Organization
GUSTAVO A MONDRAGON MD A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUSTAVO ARTURO MONDRAGON MD (PRESIDENT)
(619) 656-5252
Entity
Organization
Contact information
Practice address
480 FOURTH AVE STE 500, CHULA VISTA, CA 91910-4414
(619) 656-5252
Mailing address
480 FOURTH AVE STE 500, CHULA VISTA, CA 91910-4414
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A40640
CA
Other
Enumeration date
10/12/2017
Last updated
10/12/2017
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