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Organization
GREGORY L WAKEMAN DO INC
Active
Organization
GREGORY L WAKEMAN DO INC
Active
Other names
La Costa Urgent Care and Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY LANCE WAKEMAN DO (CHIEF EXECUTIVE OFFICER)
(760) 603-3221
Entity
Organization
Contact information
Practice address
6971 EL CAMINO REAL, SUITE 101, CARLSBAD, CA 92009
(760) 603-3221
(760) 603-7719
Mailing address
6971 EL CAMINO REAL, SUITE 101, CARLSBAD, CA 92009
(760) 603-3221
(760) 603-7719
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A6797
CA
Other
Enumeration date
10/13/2006
Last updated
10/30/2007
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