Individual
MR. KEVIN RUSSELL O'ROURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4040 30TH ST, SAN DIEGO, CA 92104-2684
(619) 515-2454
(619) 692-0478
Mailing address
4040 30TH ST, SAN DIEGO, CA 92104-2684
(619) 515-2454
(619) 692-0478
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
09/26/2012
Last updated
09/26/2012
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