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Individual

GUSTAVO ARTURO MONDRAGON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
480 FOURTH AVE STE 500, CHULA VISTA, CA 91910-4414
(619) 656-5252
(619) 656-5250
Mailing address
480 FOURTH AVE STE 500, CHULA VISTA, CA 91910-4414
(619) 656-5252
(619) 656-5250

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A40640
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A406400
CA
Enumeration date
08/17/2006
Last updated
08/26/2021
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