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1508231606
DURELL JACOBS
SAN DIEGO, CA
NPI
1508231606
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
(Licence: CA 1710l1002X-)
Enumeration Date
2015-12-01
Last Update Date
2015-12-01
Business Address
-- DURELL JACOBS IDC
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-5291
Phone number: 619-532-7968
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Mailing Address
-- DURELL JACOBS IDC
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-5291
Phone number: 619-532-7968
Copy
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