Individual
ROBERT FU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
34101 FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134-7000
(707) 230-0807
Mailing address
1638 ARROYO SIERRA DR, SANTA ROSA, CA 95405-7766
(707) 230-0807
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
09/13/2017
Last updated
09/13/2017
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