Individual
JUN Q MO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3020 CHILDRENS WAY, SAN DIEGO, CA 92123-4223
(858) 966-5944
Mailing address
3020 CHILDRENS WAY, MC5003, SAN DIEGO, CA 92123-4223
(858) 309-6300
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A72760
CA
207ZP0213X
Pediatric Pathology Physician
35.084285
OH
Other
Enumeration date
09/26/2006
Last updated
03/14/2016
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