Individual
OLEG M GAVRILYUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6699 ALVARADO RD, STE. 2302, SAN DIEGO, CA 92120-5244
(619) 578-2518
(619) 501-6498
Mailing address
6699 ALVARADO RD, STE 2302, SAN DIEGO, CA 92120-5241
(619) 578-2518
(619) 501-6498
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A74418
CA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
74418
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A74418
MEDICAL LICENSE
CA
Enumeration date
10/03/2006
Last updated
11/17/2016
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