Provider Demographics
NPI:1508202722
Name:HOWE, JOHN DAVID (SFIDC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:HOWE
Suffix:
Gender:M
Credentials:SFIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10220 COLLETT WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-2904
Mailing Address - Country:US
Mailing Address - Phone:843-476-2422
Mailing Address - Fax:
Practice Address - Street 1:10220 COLLETT WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92124-2904
Practice Address - Country:US
Practice Address - Phone:843-476-2422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman
Provider Identifiers
StateIdentifier IDID TypeIssuer
1710-1002XIDCOtherIDC