TAVIS SCOTT BUCKINGHAM

SAN DIEGO, CA
NPI1659587871
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2007-05-15
Last Update Date2007-07-08
Business Address
Mr. TAVIS SCOTT BUCKINGHAM IDC
USS NEW ORLEANS (LPD 18) FPO AP 96673-1701 COMMANDING OFFICER
SAN DIEGO, CA 92123
Phone number: 619-849-1480
Mailing Address
Mr. TAVIS SCOTT BUCKINGHAM IDC
4837 SHIELDS ST
SAN DIEGO, CA 92124-2930
Phone number: 858-822-8904
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