Individual
FERNAND MIGUEL DEFANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
3844 SWIFT AVE APT 3, SAN DIEGO, CA 92104-3182
(619) 609-5870
Mailing address
3844 SWIFT AVE APT 3, SAN DIEGO, CA 92104-3182
(619) 609-5870
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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