COLLIN JOHANSEN

SAN DIEGO, CA
NPI1396389334
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171000000X Military Health Care Provider
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2019-11-02
Last Update Date2019-11-02
Business Address
COLLIN JOHANSEN
4101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-0001
Phone number: 469-570-8106
Mailing Address
COLLIN JOHANSEN
SWMI
SAN DIEGO, CA 92134-0001
Phone number: 469-570-8106
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