Organization
SUSAN P DETWILER MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN P DETWILER MD (PRESIDENT)
(858) 539-7300
Entity
Organization
Contact information
Practice address
7110 CAMINITO PEPINO, LA JOLLA, CA 92037-5721
(858) 539-7300
(858) 539-7305
Mailing address
7076 CAMINITO VALVERDE, LA JOLLA, CA 92037-5723
(858) 539-7300
(858) 539-7300
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
G75321
CA
Other
Enumeration date
05/22/2007
Last updated
02/18/2009
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