Individual
RYAN GREGORY GARDINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
I.D.C.
Contact information
Practice address
2348 TRIDENT WAY, SAN DIEGO, CA 92155-5508
(910) 280-2206
Mailing address
4663 MUIR AVE, SAN DIEGO, CA 92107-2243
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/23/2012
Last updated
04/23/2012
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