Individual
ANDREA LYNN LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1075 CAMINO DEL RIO S, SAN DIEGO, CA 92108-3538
(619) 881-4500
Mailing address
1075 CAMINO DEL RIO S, SAN DIEGO, CA 92108-3538
(619) 881-4500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA18134
CA
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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