Individual
JOE ANTHONY SEPULVEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4065 3RD AVE, SAN DIEGO, CA 92103-2184
(619) 255-5120
Mailing address
401 QUARRY ROAD, ROOM 2204, STANFORD, CA 94025
(650) 617-2623
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A113283
CA
Other
Enumeration date
05/28/2010
Last updated
03/17/2018
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