Luis F Cordova, IDC
Military Health Care Provider, Independent Duty Corpsman in Fpo, ZZ. Individual provider (NPI-1).
NPI number1114123791
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1114123791
- Entity type
- Individual (NPI-1)
- Name
- Luis F Cordova
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 21, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1710I1002X | Military Health Care Provider, Independent Duty Corpsman | – | – | Yes |
Practice location
1st Medical Battalion 1st Marine Logistic GroupCamp Pendleton
Fpo, ZZ
Phone 760-725-4041
Mailing address
1st Medical Battalion 1st Marine Logistic GroupCamp Pendleton
Fpo, ZZ
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