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1487928057
MITCHEL GRANDE DEGUZMAN
SAN DIEGO, CA
NPI
1487928057
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2012-02-29
Last Update Date
2012-02-29
Business Address
Mr. MITCHEL GRANDE DEGUZMAN IDC
34101 FARENHOLT AVE BUILDING 14
SAN DIEGO, CA 92134-5291
Phone number: 619-252-8557
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Mailing Address
Mr. MITCHEL GRANDE DEGUZMAN IDC
PO BOX 555381
CAMP PENDLETON, CA 92055-5381
Phone number: 760-725-8805
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