Individual provider · NPI-1

Hermin Alex Acosta, IDC

Military Health Care Provider, Independent Duty Corpsman · San Diego, CA

NPI number1285076802
StatusActive
Last updated in NPPESJul 24, 2013

Details

NPI
1285076802
Entity type
Individual (NPI-1)
Name
Mr. Hermin Alex Acosta
Credential
IDC
Sex
Male
Sole proprietor
No
Enumeration date
Jul 24, 2013
Last updated
Jul 24, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1710I1002X Military Health Care Provider, Independent Duty Corpsman––Yes

Practice location

34101 Farenholt Ave
San Diego, CA 92134-7000

Phone 619-532-6195

Mailing address

830 Cerrissa St
San Diego, CA 92154-1207

Phone 210-313-7186

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