Individual
DAVID R. GWYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
22691 PLAZA DRIVE, SUITE 250, MISSION VIEJO, CA 92691
(949) 364-0225
(949) 364-9014
Mailing address
22691 PLAZA DRIVE, SUITE #250, MISSION VIEJO, CA 92691
(949) 364-0225
(949) 364-9014
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G86237
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G862370
BLUE SHIELD
CA
Enumeration date
07/21/2006
Last updated
01/10/2020
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