Individual
GILBERT ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
USS VANDEGRIFT FFG 48, NAVAL STATION 32ND ST, SAN DIEGO, CA 92136-2007
(619) 556-4740
Mailing address
3355 JORDAN PL, SAN DIEGO, CA 92123-2007
(619) 818-5743
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
B8031502
CA
Other
Enumeration date
05/05/2014
Last updated
05/05/2014
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