JOSHUA BRENT DEHAVEN

SAN DIEGO, CA
NPI1457638546
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2011-11-03
Last Update Date2011-11-03
Business Address
-- JOSHUA BRENT DEHAVEN IDC
2642 TRIDENT WAY BLDG 616
SAN DIEGO, CA 92155-5492
Phone number: 331-425-9749
Mailing Address
-- JOSHUA BRENT DEHAVEN IDC
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-7000
Phone number: 331-425-9749
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