Individual
WAYNE DAVID OVERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNS
Contact information
Practice address
VA SAN DIEGO HEALTHCARE SYSTEM, 3350 LA JOLLA VILLAGE DRIVE, SAN DIEGO, CA 92161-0001
(858) 552-8585
Mailing address
10406 WILD ORCHID WAY, SAN DIEGO, CA 92127-2876
(858) 254-0568
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
501535
CA
Other
Enumeration date
07/16/2008
Last updated
07/16/2008
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