Individual
PAUL RICKY ENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
BLDG 13129, 14 TH ST, CAMP PENDLETON, CA 92055
(760) 725-2194
Mailing address
NHCP BLDG H-100 SANTA MARGARITA RD, CAMP PENDLETON, CA 92055
(760) 763-6529
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/13/2008
Last updated
08/30/2013
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