Organization
IDAHOSURGEONS NET PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN C. MAYBERRY MD (PRESIDENT)
(858) 565-0104
Entity
Organization
Contact information
Practice address
7910 FROST ST STE 250, SAN DIEGO, CA 92123-2752
(858) 565-0104
(844) 213-3678
Mailing address
7910 FROST ST STE 250, SAN DIEGO, CA 92123-2752
(858) 565-0104
(844) 213-3678
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
G151173
CA
Other
Enumeration date
03/07/2018
Last updated
03/22/2018
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