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1275152654
KENNETH EDWARD SIEBERT
SAN DIEGO, CA
NPI
1275152654
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2020-04-15
Last Update Date
2020-04-15
Business Address
KENNETH EDWARD SIEBERT IDC
4831 SHIELDS ST
SAN DIEGO, CA 92124-2930
Phone number: 619-332-9330
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Mailing Address
KENNETH EDWARD SIEBERT IDC
4831 SHIELDS ST
SAN DIEGO, CA 92124-2930
Phone number: 619-332-9330
Copy
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