Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Pediatrics
Enumerated
Jan 23, 2012
License(s)
NP95003999 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 3020 CHILDRENS WAY MC5003 | San Diego, CA 92123-4223 | 858-309-6300 |
| LOCATION | 7910 FROST ST | San Diego, CA 92123-2771 | 858-966-8974 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.