Individual
DEREK GAGNON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3985 CUMMINGS RD, STE 4, SAN DIEGO, CA 92136-5218
(619) 572-8192
Mailing address
8301 RIO SAN DIEGO DR, #21, SAN DIEGO, CA 92108-5686
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20565
SC
Other
Enumeration date
03/15/2006
Last updated
07/08/2007
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