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1811744907
MODERN MAN TRT LLC
SAN DIEGO, CA
NPI
1811744907
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Entity Type
Organization
Authorized Contact
JOHN HORTAREAS
Owner
619-356-8973
Organization Subpart ?
No
Primary Taxonomy
207R00000X Internal Medicine
Enumeration Date
2024-05-06
Last Update Date
2024-05-06
Business Address
MODERN MAN TRT LLC
4306 W POINT LOMA BLVD APT D
SAN DIEGO, CA 92107-1165
Phone number: 619-356-8973
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Mailing Address
MODERN MAN TRT LLC
4306 W POINT LOMA BLVD APT D
SAN DIEGO, CA 92107-1165
Phone number: 619-356-8973
Copy
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