Michael Thomas Short
Military Health Care Provider, Independent Duty Corpsman in San Diego, CA. Individual provider (NPI-1).
NPI number1184046815
StatusActive
Last updated in NPPESJan 15, 2014
Details
- NPI
- 1184046815
- Entity type
- Individual (NPI-1)
- Name
- Michael Thomas Short
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 15, 2014
- Last updated
- Jan 15, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1710I1002X | Military Health Care Provider, Independent Duty Corpsman | – | – | Yes |
Practice location
15034 Avenida MontuosaApt B
San Diego, CA 92129-1442
Phone 949-682-6918
Mailing address
15034 Avenida MontuosaApt B
San Diego, CA 92129-1442
Phone 949-682-6918
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