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Individual

MATTHEW EDWARD BOLERJACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7130 MIRAMAR RD STE 400, SAN DIEGO, CA 92121-2340
(619) 609-3171
Mailing address
6879 OROLA LN, LA MESA, CA 91942-4525
(619) 609-3171

Taxonomy

Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
104470
CA

Other

Enumeration date
04/15/2022
Last updated
04/15/2022
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