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Individual

DR. GREGORY SPENCER MYNKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
32475 OAK KNOLL LN, LAKE ELSINORE, CA 92530-8324
(951) 609-5028
(951) 678-4287
Mailing address
32475 OAK KNOLL LN, LAKE ELSINORE, CA 92530-8324
(951) 609-5028
(951) 678-4287

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
G 74144
CA
208D00000X
General Practice Physician
Primary
G74144
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G 74144
CA STATE MEDICAL LICENSE
CA
Enumeration date
08/03/2006
Last updated
07/16/2024
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