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Organization
SHOTA GURTCH, M.D., INC., A PROFESSIONAL CORPORATION
Active
Organization
SHOTA GURTCH, M.D., INC., A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHOTA GURCHUMELIDZE MD (PHYSICIAN)
(858) 997-3161
Entity
Organization
Contact information
Practice address
8875 LA MESA BLVD STE C, LA MESA, CA 91942-5434
(619) 668-8100
Mailing address
8875 LA MESA BLVD STE C, LA MESA, CA 91942-5434
(619) 668-8100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/31/2023
Last updated
08/31/2023
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