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Individual

HAKIEM CLARKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(860) 694-3748
Mailing address
9914 GANTNER SQ, SAN DIEGO, CA 92131-2507
(910) 478-5321

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
01/13/2015
Last updated
01/13/2015
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