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1073249918
MARK SAMEH MIKHAIL
SAN DIEGO, CA
NPI
1073249918
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2022-07-25
Last Update Date
2022-07-25
Business Address
MARK SAMEH MIKHAIL RADT
3145 IMPERIAL AVE
SAN DIEGO, CA 92102-4319
Phone number: 909-296-2508
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Mailing Address
MARK SAMEH MIKHAIL RADT
3145 IMPERIAL AVE
SAN DIEGO, CA 92102-4319
Phone number: 909-296-2508
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