Individual
TRACY VANDEWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15611 POMERADO RD STE 400, POWAY, CA 92064-2437
(858) 618-1191
Mailing address
15611 POMERADO RD STE 400, POWAY, CA 92064-2437
(858) 485-7870
(858) 485-6473
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
A186032
CA
Other
Enumeration date
03/21/2018
Last updated
12/19/2025
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