Individual
SEAN PATRICK OVERLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
2496 BAUER RD., BMC MCAS MIRAMAR, SAN DIEGO, CA 92145
(858) 577-9864
(858) 577-9965
Mailing address
2496 BAUER RD., BMC MCAS MIRAMAR, SAN DIEGO, CA 92145
(858) 577-9864
(858) 577-9965
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
02/06/2009
Last updated
02/06/2009
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