Individual
GILBERT CORPUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
US NAVY IDC
Contact information
Practice address
34101 FARENHOLT AVE, BUILDING 14, SAN DIEGO, CA 92134-7000
(619) 532-9428
Mailing address
PSC 819 BOX 4340, FPO, AE 09645-0044
(001) 349-5682
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
US NAVY IDC
CA
1710I1002X
Independent Duty Corpsman
Primary
1750757134
CA
247200000X
Other Technician
US NAVY IDC
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
US NAVY IDC
US NAVY
CA
Enumeration date
08/19/2015
Last updated
01/20/2022
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