Individual
RON ALAN MACNUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8929 UNIVERSITY CENTER LN, SUITE 201, SAN DIEGO, CA 92122-1006
(858) 450-4199
Mailing address
3750 CONVOY ST, STE 201, SAN DIEGO, CA 92111-3770
(858) 278-8300
(858) 569-1337
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA17570
CA
Other
Enumeration date
01/22/2009
Last updated
07/10/2017
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