Individual
DR. KATHLEEN MARY DULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3020 CHILDRENS WAY, MC 5014, SAN DIEGO, CA 92123-4223
(858) 966-5980
(858) 312-5360
Mailing address
3020 CHILDRENS WAY, MC 5014, SAN DIEGO, CA 92123-4223
(858) 966-5980
(858) 312-5360
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G72961
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G729610
MEDI-CAL
CA
Enumeration date
08/10/2005
Last updated
09/21/2009
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