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Individual

MR. RYAN THOMAS CAMPBELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
34101 FARENHOLT AVE, BUILDING 14, SAN DIEGO, CA 92134-5291
(818) 434-8387
Mailing address
34101 FARENHOLT AVE, BULIDING 14, SAN DIEGO, CA 92134-5291
(818) 434-8387

Taxonomy

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

Other

Enumeration date
12/04/2012
Last updated
12/04/2012
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