Individual
XI CAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9300 CAMPUS POINT DR # MC7723, LA JOLLA, CA 92037-1300
(858) 657-6772
(858) 657-5495
Mailing address
9300 CAMPUS POINT DR # MC7723, LA JOLLA, CA 92037-1300
(858) 657-6772
(858) 657-5495
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
PTL13242
CA
Other
Enumeration date
12/07/2023
Last updated
12/07/2023
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