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Organization
SOUTHBAY NEUROLOGICAL MED GR
Active
Organization
SOUTHBAY NEUROLOGICAL MED GR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLANCA GAMBOA CPC (OFFICE MANAGER)
(619) 585-7227
Entity
Organization
Contact information
Practice address
360 H ST, CHULA VISTA, CA 91910-5511
(619) 585-7227
(619) 585-3190
Mailing address
360 H ST, CHULA VISTA, CA 91910-5511
(619) 585-7227
(619) 585-3190
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2084N0400X
CA
Other
Enumeration date
03/08/2006
Last updated
03/18/2014
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