Individual
BOYLE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3875 AVOCADO BLVD., SAN DIEGO, CA 91941
(800) 290-5000
Mailing address
3875 AVOCADO BLVD., SAN DIEGO, CA 91941
(800) 290-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G66902
CA
Other
Enumeration date
01/30/2006
Last updated
07/16/2007
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