Individual
MICHELLE KAUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
34800 BOB WILSON DR INFECTIOUS DISEASE CLINIC, SAN DIEGO, CA 92134-2111
(619) 532-7475
Mailing address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-7475
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
207RI0200X
Infectious Disease Physician
Primary
0102206737
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Enumeration date
04/17/2020
Last updated
05/07/2025
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