Organization
BALBOA PARK INTERNAL MEDICINE, MEDICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY WOODALL M.D. (PRESIDENT)
(619) 260-3456
Entity
Organization
Contact information
Practice address
2970 5TH AVE, SUITE #140, SAN DIEGO, CA 92103-5929
(619) 260-3456
Mailing address
2970 5TH AVE, SUITE #140, SAN DIEGO, CA 92103-5929
(619) 260-3456
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A54031
CA
Other
Enumeration date
01/03/2007
Last updated
04/27/2011
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