Individual
FERNANDO MEDIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9300 CAMPUS POINT DR, LA JOLLA, CA 92037-1300
(858) 657-8540
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP95005764
CA
Other
Enumeration date
09/20/2015
Last updated
09/25/2017
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