Individual
MR. CLEVELAND EUGENE GARDNER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3132 JEFFERSON ST, SAN DIEGO, CA 92110-4421
(619) 683-3100
Mailing address
3132 JEFFERSON ST, SAN DIEGO, CA 92110-4421
(619) 683-3100
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
175T00000X
Peer Specialist
Primary
MPSS-TWDEFS
CA
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/06/2016
Last updated
02/02/2026
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