Individual
JASON DOUGLAS BEADORE-MINOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SFIDC
Contact information
Practice address
34101 FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134-5291
(619) 532-7968
(619) 532-8251
Mailing address
34101 FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134-5291
(619) 532-7968
(619) 532-8251
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
01/27/2018
Last updated
01/27/2018
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