Individual
MR. TIMOTHY DANIEL SEVERINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SOIDC
Contact information
Practice address
1ST RECONNAISSANCE BATTALION AID STATION, 41 AREA CAMP FLORES, CAMP PENDLETON, CA 92055
(760) 725-8912
Mailing address
1ST RECONNAISSANCE BATTALION AID STATION, 41 AREA CAMP FLORES, PO BOX 555584, CAMP PENDLETON, CA 92055
(760) 725-8912
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
NC
Other
Enumeration date
10/16/2015
Last updated
10/16/2015
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