Most Relevant Information
Provider Data
| NPI Number: | 1003361742 |
| Provider Name: | CALEB JAMES HAYNIE IDC |
| Entity Type: | Individual |
| Taxonomy Code: | 1710I1002X |
| Specialty: | Military Health Care Provider |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/23/2016 |
| Last Updated: | 08/23/2016 |
Provider Practice Location
3423 GUADALCANAL RD BLDG 401 2ND DECK
SEAL TEAM SEVENTEEN
CORONADO
CA
921555599
Practice Location Phone/Fax
| Phone: | 6195371334 |
| Fax: | 6194372068 |
Provider Mailing Location
3423 GUADALCANAL RD BLDG 401 2ND DECK
SEAL TEAM SEVENTEEN
CORONADO
CA
921555599
Provider Mailing Phone/Fax
| Phone: | 6195371334 |
| Fax: | 6194372068 |