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Individual

MR. EDSEL CONDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A., M.M.S.

Contact information

Practice address
1809 NATIONAL AVE, SAN DIEGO, CA 92113-2113
(619) 515-2300
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2300

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
53129
CA
363A00000X
Physician Assistant
PA.PA.60615465
WA
363A00000X
Physician Assistant
PA60615465
WA

Other

Enumeration date
12/24/2015
Last updated
06/24/2024
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