Individual
OLIVER HIPOLITO BANAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(619) 306-6011
Mailing address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(619) 306-6011
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
11/14/2011
Last updated
11/14/2011
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