Individual
GEORGE THOMAS STEVENS IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC (NAVY)
Contact information
Practice address
3330 TARAWA RD BLDG 327, SAN DIEGO, CA 92155-5078
(619) 437-5139
(619) 437-5099
Mailing address
3330 TARAWA RD BLDG 327, SAN DIEGO, CA 92155-5078
(619) 437-5139
(619) 437-5099
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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