Registry details
Type
Individual
Primary specialty
Family Medicine, Sports Medicine
Enumerated
May 24, 2017
License(s)
20A18184 (CA), 20A18184 (CA), 20A18184 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 10790 RANCHO BERNARDO RD | San Diego, CA 92127-5705 | 858-605-7960 |
| LOCATION | 15004 INNOVATION DR | San Diego, CA 92128-3491 | 858-605-7960 |
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