Individual
ANGELA GAYNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
734 10TH AVE, SAN DIEGO, CA 92101-6502
(619) 239-4663
Mailing address
734 10TH AVE, SAN DIEGO, CA 92101-6502
(619) 239-4663
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95221306
CA
Other
Enumeration date
06/17/2020
Last updated
03/17/2021
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