Individual
MARY LORAINE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
133 W MAIN ST # 240, EL CAJON, CA 92020-3315
(619) 401-0404
Mailing address
133 W MAIN ST # 240, EL CAJON, CA 92020-3315
(619) 401-0404
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
132556
CA
Other
Enumeration date
07/10/2009
Last updated
04/02/2018
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