Individual
DR. CI MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7850 VISTA HILL AVE, SAN DIEGO, CA 92123-2717
(858) 848-5386
Mailing address
PO BOX 711563, SAN DIEGO, CA 92171-1563
(858) 848-5386
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A134158
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A134158
MEDICAL LICENSE
CA
Enumeration date
04/04/2011
Last updated
02/02/2023
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