Individual
THUC DAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RT
Contact information
Practice address
4647 ZION AVE, SAN DIEGO, CA 92120-2507
(619) 528-5019
Mailing address
3701 54TH ST, SAN DIEGO, CA 92105-3209
(619) 265-8290
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
24312
CA
Other
Enumeration date
08/11/2018
Last updated
08/11/2018
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