Gary Cherry Jr., IDC
Military Health Care Provider, Independent Duty Corpsman in San Diego, CA. Individual provider (NPI-1).
NPI number1316197056
StatusActive
Last updated in NPPESSep 30, 2008
Details
- NPI
- 1316197056
- Entity type
- Individual (NPI-1)
- Name
- Mr. Gary Cherry Jr.
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 30, 2008
- Last updated
- Sep 30, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1710I1002X | Military Health Care Provider, Independent Duty Corpsman | – | – | Yes |
Practice location
35000 Guadalcanal StBranch Medical Clinic Mcrd
San Diego, CA 92140
Phone 619-524-4045
Mailing address
35000 Guadalcanal StBranch Medical Clinic Mcrd
San Diego, CA 92140
Phone 619-524-4045
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