Individual
MR. JOSHUA SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
MAG -39 MEDICAL, CAMP PEDNLTEON, CAMP PEDNLETON, CA 92055
(760) 725-2969
Mailing address
207 CALDERA LN, HEMET, CA 92545-9359
(951) 259-0396
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710I1002X
INDEPENDENT DUTY CORPSMAN
CA
Enumeration date
05/29/2007
Last updated
07/08/2007
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