Individual
MRS. AMANDA WILLIAMS GUMBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
6645 ALVARADO RD, SUITE# 4000, SAN DIEGO, CA 92120-5208
(619) 810-1010
(619) 810-1011
Mailing address
6645 ALVARADO RD, SUITE# 4000, SAN DIEGO, CA 92120-5208
(619) 810-1010
(619) 810-1011
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA18153
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA18153
—
CA
Enumeration date
06/29/2006
Last updated
02/11/2015
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