Individual
MR. OSAZUWA MICHAEL IGHOOSAGIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-9712
Mailing address
1870 PISA CIR, STOCKTON, CA 95206-6321
(209) 430-0676
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
10/03/2018
Last updated
10/03/2018
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