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Individual

GAURAV MISHRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
678 3RD AVE, CHULA VISTA, CA 91910-5736
(619) 662-4100
Mailing address
1601 PRECISION PARK LN, SAN YSIDRO, CA 92173-1345
(196) 624-1006

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
A129941
CA
2084P0802X
Addiction Psychiatry Physician
A129941
CA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
A129941
CA

Other

Enumeration date
07/22/2009
Last updated
11/07/2019
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