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Individual

KELLY GREEN MAZUREK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4510 VIEWRIDGE AVE, SAN DIEGO, CA 92123
(866) 413-1582
Mailing address
4510 VIEWRIDGE AVE, SAN DIEGO, CA 92123-1637
(866) 413-1582

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A149649
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/07/2012
Last updated
11/29/2021
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