Individual
ELI YOSAIM HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DEEP SEA IDC
Contact information
Practice address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-0097
(619) 532-6723
Mailing address
34101 FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134-7000
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
03/31/2014
Last updated
10/16/2024
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