Organization
MIRA MESA BUSINESS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVIS DUONG (SECRETARY)
(858) 380-7530
Entity
Organization
Contact information
Practice address
9460 MIRA MESA BLVD, SUITE L, SAN DIEGO, CA 92126-4851
(858) 863-7246
(858) 252-2650
Mailing address
9460 MIRA MESA BLVD, SUITE L, SAN DIEGO, CA 92126-4851
(858) 863-7246
(858) 252-2650
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
02/01/2017
Last updated
02/01/2017
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