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Individual

DR. ADRIENNE ERTL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
9999 MIRA MESA BLVD STE 104, SAN DIEGO, CA 92131-1006
(858) 271-6962
(858) 271-5327
Mailing address
9999 MIRA MESA BLVD STE 104, SAN DIEGO, CA 92131-1006
(858) 271-6962
(858) 271-5327

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A67804
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A67804
LICENSE
CA
Enumeration date
12/01/2006
Last updated
03/15/2010
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