Individual
DR. MATTHEW JEROME MCGINNISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD FACMG
Contact information
Practice address
9410 CARROLL PARK DR, SAN DIEGO, CA 92121-5201
(858) 882-5986
(858) 410-6822
Mailing address
15485 ANDORRA WAY, SAN DIEGO, CA 92129-1107
(858) 882-5986
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
ABMG-96135
CA
170100000X
Ph.D. Medical Genetics
Primary
DRN 9
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ABMG-96135
MEDICAL GENETICS PHD
—
01
—
DRN9
CL GENETIC MOLECULAR BIOL
CA
Enumeration date
06/22/2007
Last updated
07/08/2007
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