Individual
GARY M VILKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(858) 249-6750
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
(858) 249-6773
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G78057
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G780570
—
CA
Enumeration date
06/15/2006
Last updated
02/02/2019
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