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Organization

SHOTA GURTCH, M.D., INC. A PROFESSIONAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHOTA GURCHUMELIDZE MD (PHYSICIAN)
(858) 997-3161
Entity
Organization

Contact information

Practice address
8875 LA MESA BLVD STE C, LA MESA, CA 91942-5434
(619) 668-8100
(619) 667-2688
Mailing address
8875 LA MESA BLVD STE C, LA MESA, CA 91942-5434
(619) 668-8100
(619) 667-2688

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary

Other

Enumeration date
06/07/2022
Last updated
08/31/2023
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