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Organization
SOUTHLAND MED GROUP
Active
Organization
SOUTHLAND MED GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL B BUNIM MD (CEO)
(619) 788-4570
Entity
Organization
Contact information
Practice address
1804 GARNET AVE, SUITE 461, SAN DIEGO, CA 92109-3352
(619) 788-4570
Mailing address
1804 GARNET AVE, SUITE 461, SAN DIEGO, CA 92109-3352
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G18820
CA
Other
Enumeration date
05/02/2009
Last updated
09/15/2009
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