Individual
KYLE LEONARD GOSSELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
2600 DODSON ST STE 3, PORT HUENEME, CA 93043-4432
(805) 342-9300
(805) 915-1794
Mailing address
2600 DODSON ST STE 3, PORT HUENEME, CA 93043-4432
(805) 342-9300
(805) 915-1794
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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