# OLEG M. GAVRILYUK, M.D., PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144777590
- **Authorized official:** OLEG M GAVRILYUK M.D. (OWNER)
- **Authorized official phone:** (619) 764-0330

## Contact information

- **Practice address:** 6699 ALVARADO RD, \#2302, SAN DIEGO, CA 92120-5244
- **Practice address phone:** (619) 764-0330
- **Mailing address:** 6699 ALVARADO RD, \#2302, SAN DIEGO, CA 92120-5244

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/01/2016
- **Last updated:** 09/01/2016