Individual
GARY VANDENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9834 GENESEE AVE, SUITE 326, LA JOLLA, CA 92037-1223
(858) 453-3813
(858) 453-1727
Mailing address
9834 GENESEE AVE, SUITE 326, LA JOLLA, CA 92037-1223
(858) 453-3813
(858) 453-1727
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
C33053
CA
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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