1114123791

Everything you always wanted to know about CORDOVA F LUIS IDC but were afraid to ask.

CORDOVA F LUIS IDC

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Provider Last Name Provider Middle Name Provider First Name Provider Credential
CORDOVA F LUIS IDC
Gender:
Male
Enumeration date:
2007-06-21
Last update date:
2007-07-08
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
171000000X Military Health Care Provider none none

Phone Numbers

Type Number
Practice Location Address Telephone Number 7607254041

Addresses

Type Address City State Postal Country
Mailing Address 1ST MEDICAL BATTALION 1ST MARINE LOGISTIC GROUP CAMP PENDLETON FPO US 92055 US
Practice Location Address 1ST MEDICAL BATTALION 1ST MARINE LOGISTIC GROUP CAMP PENDLETON FPO US 92055 US