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1902016363
PAUL M DERTIEN
SAN FRANCISCO, CA
NPI
1902016363
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-05-23
Last Update Date
2007-07-08
Business Address
Mr. PAUL M DERTIEN
995 POTRERO AVE WARD 93
SAN FRANCISCO, CA 94110-2859
Phone number: 415-206-8412
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Mailing Address
Mr. PAUL M DERTIEN
3769 CESAR CHAVEZ APT A
SAN FRANCISCO, CA 94110-4316
Phone number: 415-648-2661
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