Organization
GENSI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEE MCCRACKEN (CHIEF EXECUTIVE OFFICER)
(858) 270-1594
Entity
Organization
Contact information
Practice address
11125 FLINTKOTE AVE, SUITE J, SAN DIEGO, CA 92121-1213
(858) 270-1594
(858) 408-7545
Mailing address
11125 FLINTKOTE AVE, SUITE J, SAN DIEGO, CA 92121-1213
(858) 270-1594
(858) 408-7545
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D2102775
CA
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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