Individual
CORA S HUMBERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10666 N TORREY PINES RD, LA JOLLA, CA 92037-1027
(858) 554-9100
Mailing address
10790 RANCHO BERNARDO RD, SAN DIEGO, CA 92127-5705
(858) 554-8605
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
C64369
CA
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
G64369
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
C64369
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G643690
—
CA
Enumeration date
11/01/2006
Last updated
04/06/2017
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