Individual
MR. JON RYAN O'HARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
SPECIAL BOAT TEAM TWELVE 3402 TARAWA ROAD, SAN DIEGO, CA 92155-9227
(619) 437-5540
Mailing address
7749 CALLE ANDAR, CARLSBAD, CA 92009-9227
(760) 585-6160
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
07/26/2013
Last updated
05/15/2025
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