Organization
ARISTAMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANILLE LOGSDON (SPECIALIST NETWORK MANAGER)
(816) 916-3289
Entity
Organization
Contact information
Practice address
4660 LA JOLLA VILLAGE DR STE 100-1535, SAN DIEGO, CA 92122-4601
(858) 751-4777
Mailing address
4755 NEXUS CENTER DR, SAN DIEGO, CA 92121-3051
(858) 750-4777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/16/2016
Last updated
07/07/2023
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