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1164245403
EDGAR MANUEL GONZALEZGOMEZ
SAN DIEGO, CA
NPI
1164245403
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2024-11-05
Last Update Date
2024-11-05
Business Address
EDGAR MANUEL GONZALEZGOMEZ IDC
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-7000
Phone number: 619-532-6266
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Mailing Address
EDGAR MANUEL GONZALEZGOMEZ IDC
4765 GURKE ST
SAN DIEGO, CA 92124-2915
Phone number: 323-365-9491
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