Individual
REGINA M OTTEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
4311 3RD AVE, SAN DIEGO, CA 92103-1407
(619) 688-1600
Mailing address
4311 3RD AVE, SAN DIEGO, CA 92103-1407
(619) 688-1600
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
12322
CA
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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