Individual
MARY WALCH DU QUETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2020 GENESEE AVE, SAN DIEGO, CA 92123-4219
(858) 616-8100
(858) 569-5209
Mailing address
2020 GENESEE AVE, SAN DIEGO, CA 92123-4219
(858) 616-8100
(858) 569-5209
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
G70844
CA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
G70844
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G708440
—
CA
Enumeration date
08/09/2006
Last updated
06/18/2013
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