ERNEST CLARENCE KOANI SMITH

SAN DIEGO, CA
NPI1275308025
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2023-11-21
Last Update Date2023-12-07
Business Address
ERNEST CLARENCE KOANI SMITH (IDC)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-4856
Phone number: 808-492-7003
Mailing Address
ERNEST CLARENCE KOANI SMITH (IDC)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-4856
Phone number: 808-492-7003
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