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1104131077
EDGAR M. SANTIAGO
SAN DIEGO, CA
NPI
1104131077
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2010-08-16
Last Update Date
2010-08-16
Business Address
Mr. EDGAR M. SANTIAGO IDC
SURFACE WARFARE MEDICINE INST 34101 FARENHOLT AVE
SAN DIEGO, CA 92134-7000
Phone number: 619-532-5136
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Mailing Address
Mr. EDGAR M. SANTIAGO IDC
1391 SUTTER BUTTES ST
CHULA VISTA, CA 91913-2944
Phone number: 629-532-5136
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