Organization
SITI MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN ANN KINCAID FNP (PART OWNER/ MANGER)
(619) 717-8484
Entity
Organization
Contact information
Practice address
1951 4TH AVE STE 202, SAN DIEGO, CA 92101-2374
(619) 717-8484
Mailing address
1951 4TH AVE #202, SAN DIEGO, CA 92101
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
18150
CA
Other
Enumeration date
12/07/2010
Last updated
12/07/2010
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