Individual
GREGORY CLIFFORD NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-7611
Mailing address
2713 MANZANO, MISSION VIEJO, CA 92692
(949) 412-7695
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1121110
CA
Other
Enumeration date
11/20/2014
Last updated
11/20/2014
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