Individual provider · NPI-1

Mario Travers Adams, IDC

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

NPI number1669180972
StatusActive
Last updated in NPPESNov 7, 2022

Details

NPI
1669180972
Entity type
Individual (NPI-1)
Name
Mario Travers Adams
Credential
IDC
Sex
Male
Sole proprietor
No
Enumeration date
Nov 7, 2022
Certification date
Nov 7, 2022
Last updated
Nov 7, 2022

Taxonomy and licenses

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

Practice location

1767 Torrance St Apt 312
San Diego, CA 92103-2730

Phone 252-525-1818

Mailing address

1767 Torrance St Apt 312
San Diego, CA 92103-2730

Phone 252-525-1818

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