DERICK MEDINA

SAN DIEGO, CA
NPI1669862413
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2015-02-02
Last Update Date2015-02-02
Business Address
Mr. DERICK MEDINA IDC
34101 FARENHOLT AVE
SAN DIEGO, CA 92134-7000
Phone number: 619-532-7714
Mailing Address
Mr. DERICK MEDINA IDC
34101 FARENHOLT AVE
SAN DIEGO, CA 92134-7000
Phone number: 619-532-7714
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