Organization
SAN DIEGO EAR HEAD & NECK SURGERY MEDICAL CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE VAN SUCH (OFFICE MANAGER)
(858) 458-9955
Entity
Organization
Contact information
Practice address
9850 GENESEE AVE, STE 710, LA JOLLA, CA 92037-1224
(858) 458-9955
(858) 452-7848
Mailing address
9850 GENESEE AVE, STE 710, LA JOLLA, CA 92037-1224
(858) 458-9955
(858) 452-7848
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
C39780
CA
Other
Enumeration date
01/26/2007
Last updated
08/22/2020
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