Individual
MR. DENNIS PANSACOLA RAYMUNDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SFIDC
Contact information
Practice address
H100 SANTA MARGARITA RD, NAVAL HOSPITAL CAMP PENDLETON, OCEAN SIDE, CA 92058
(760) 763-6529
Mailing address
35463 SUGAR MAPLE ST, MURRIETA, CA 92563-7942
(619) 764-3059
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/07/2011
Last updated
06/07/2011
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