Individual
ELLEN M REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSNS
Contact information
Practice address
3420 KENYON ST, SAN DIEGO, CA 92110-5001
(619) 590-5121
Mailing address
3420 KENYON ST, SAN DIEGO, CA 92110-5001
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
248804
CA
Other
Enumeration date
06/27/2007
Last updated
07/08/2007
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