Individual
GARY R. CHISWICK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
150 VALPREDA RD, SAN MARCOS, CA 92069-2973
(760) 736-6780
Mailing address
150 VALPREDA RD, SAN MARCOS, CA 92069-2973
(760) 736-6780
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA22667
CA
Other
Enumeration date
07/08/2013
Last updated
03/12/2024
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