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1295353175
DEREK R SUMMERS
SAN DIEGO, CA
NPI
1295353175
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2020-07-08
Last Update Date
2020-07-08
Business Address
DEREK R SUMMERS IDC
34101 FARENHOLT AVE
SAN DIEGO, CA 92134-7000
Phone number: 619-392-5782
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Mailing Address
DEREK R SUMMERS IDC
34101 FARENHOLT AVE
SAN DIEGO, CA 92134-7000
Phone number: 619-392-5782
Copy
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