Individual
GAVIN KOLODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9095 RIO SAN DIEGO DR STE 450, SAN DIEGO, CA 92108-1726
(619) 853-8860
Mailing address
9095 RIO SAN DIEGO DR STE 410, SAN DIEGO, CA 92108-1679
(858) 357-9450
(858) 412-6376
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
20A18281
CA
Other
Enumeration date
04/05/2016
Last updated
01/12/2026
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