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1962798553
MAHTOB MAE JOHNSON
SAN DIEGO, CA
NPI
1962798553
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2011-06-22
Last Update Date
2011-06-22
Business Address
-- MAHTOB MAE JOHNSON IDC
34101 FARENHOLT AVE
SAN DIEGO, CA 92134-7000
Phone number: 619-532-9457
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Mailing Address
-- MAHTOB MAE JOHNSON IDC
34101 FARENHOLT AVE
SAN DIEGO, CA 92134-7000
Phone number:
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