Individual
BORIS GUTKOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPT1
Contact information
Practice address
55 CHUMASERO DRIVE #2D, SAN FRANCISCO, CA 94132-2319
(415) 585-5822
Mailing address
55 CHUMASERO DR APT 2D, SAN FRANCISCO, CA 94132-2319
(415) 867-2235
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CPT9570
CA
Other
Enumeration date
02/10/2016
Last updated
02/10/2016
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