Individual
KERRY O'SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3350 LA JOLLA VILLAGE DR, SAN DIEGO, CA 92161
(858) 337-8067
Mailing address
5663 BALBOA AVE # 337, SAN DIEGO, CA 92111-2705
(858) 337-8067
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0994296
CO
363L00000X
Nurse Practitioner
95009644
CA
Other
Enumeration date
02/11/2019
Last updated
02/11/2019
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