Individual
LOGAN GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-5000
(626) 993-4243
Mailing address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-5000
(626) 993-4243
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
03/06/2026
Last updated
03/06/2026
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