Individual
GABRIEL ANTHONY BOCANEGRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUB IDC
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-5112
Mailing address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-5112
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CT
Other
Enumeration date
06/09/2009
Last updated
08/02/2012
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