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Individual

DR. GHADA K KASSAB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4606 MISSION BAY DR, SAN DIEGO, CA 92109-4921
(858) 273-2726
(858) 273-2725
Mailing address
4606 MISSION BAY DR, SAN DIEGO, CA 92109-4921
(858) 273-2726
(858) 273-2725

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
01069398A
IN
207N00000X
Dermatology Physician
11013338A
IN
207N00000X
Dermatology Physician
Primary
A114457
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000720044
ANTHEM PROVIDER NUMBER
IN
05
201024080
IN
Enumeration date
06/10/2008
Last updated
05/01/2024
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