Individual
MR. FRED JOSEPH BRODIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DIVE IDC
Contact information
Practice address
2930 TARAWA RD, SAN DIEGO, CA 92155-5198
(619) 437-5962
Mailing address
2952 WELLINGTON ST, SAN DIEGO, CA 92111-5740
(808) 554-4533
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
01/07/2013
Last updated
01/07/2013
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