Individual
MS. VIVIENNE N PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9898 GENESEE AVE, LA JOLLA, CA 92037-1205
(858) 455-6330
Mailing address
10790 RANCHO BERNARDO RD, MAIL DROP 4S-205, SAN DIEGO, CA 92127-5705
(858) 824-5363
(858) 964-3112
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
52309
CA
363AS0400X
Surgical Physician Assistant
Primary
52309
CA
Other
Enumeration date
10/02/2013
Last updated
10/03/2021
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