Individual
ANDREW BISMARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3350 LA JOLLA VILLAGE DR, SAN DIEGO, CA 92161-0002
(858) 245-5825
Mailing address
3350 LA JOLLA VILLAGE DR, SAN DIEGO, CA 92161-0002
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
29689
CA
Other
Enumeration date
12/14/2017
Last updated
12/14/2017
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