Individual
WILFRED S. KEARSE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8851 CENTER DR STE 501, LA MESA, CA 91942-3033
(619) 697-2456
(858) 429-7930
Mailing address
PO BOX 33865, SAN DIEGO, CA 92163-3865
(858) 888-7700
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G83318
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G833180
—
CA
01
—
CB307684
MEDICARE ID
CA
Enumeration date
08/12/2006
Last updated
03/18/2020
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