| NPI | 1538120068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENEDICTO VICENCIO MANALANSAN Independent Duty Corpsman 619-475-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1710I1002X Military Health Care Provider, Independent Duty Corpsman |
| Enumeration Date | 2006-04-02 |
| Last Update Date | 2008-05-19 |