Individual
GARY PATRICK KRUEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3636 5TH AVE, STE.300, SAN DIEGO, CA 92103-4230
(619) 297-4331
Mailing address
3636 5TH AVE, STE.300, SAN DIEGO, CA 92103-4230
(619) 297-4331
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5295T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0052950
—
CA
Enumeration date
02/19/2007
Last updated
07/08/2007
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