Jake Garrett Theobald
Jake Garrett Theobald is an Independent Duty Corpsman in San Diego, California. Registered with an NPI since 2021.
- In the registry since
- 2021
Practice location Address checks out
34101 Farenholt AveSan Diego, CA 92134-7000
Phone: (619) 532-7968
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Independent Duty Corpsman (primary) | Taxonomy 1710I1002X |
|---|
Record details
| NPI number | 1053994327 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | May 4, 2021 |
| Last updated in NPPES | December 3, 2021 |
| Certification date | December 3, 2021 |
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Stephen Tarrants, SFIDC
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Mr. Andrew Bud Taylor, IDC
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Jose Isidro Tello, IDC
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Brandon Kyle Thieleman
34101 Farenholt Ave Bldg 14, San Diego, CA 92134-7000 · (757) 620-2575
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Brandon J Thompson, SF-IDC
34101 Farenholt Ave, San Diego, CA 92134-7000 · (405) 397-6822