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1184059578
TIMOTHY RYAN EDGAR
SAN DIEGO, CA
NPI
1184059578
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
(Licence: CA D6476308)
Enumeration Date
2013-09-04
Last Update Date
2013-09-04
Business Address
-- TIMOTHY RYAN EDGAR IDC
3883 INGRAHAM ST APT #U309
SAN DIEGO, CA 92109-6433
Phone number: 559-975-5651
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Mailing Address
-- TIMOTHY RYAN EDGAR IDC
3883 INGRAHAM ST APT #U309
SAN DIEGO, CA 92109-6433
Phone number: 559-975-5651
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