Individual
DR. GARY DEAN SHUTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D., F.A.A.O.
Contact information
Practice address
3945 1ST AVE, SAN DIEGO, CA 92103-3015
(619) 295-4194
(619) 295-4930
Mailing address
3945 1ST AVE, SAN DIEGO, CA 92103-3015
(619) 295-4194
(619) 295-4930
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8857T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0088570
—
CA
Enumeration date
11/30/2006
Last updated
01/24/2008
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