GARY VANDENBERG,JR., M.D.,INC.
Ambulatory Health at Genesee Ave, La Jolla, CA

License number
California C33053
Category
Ambulatory Health
Type
Primary Care
Owner
Name: GARY VANDENBERG M.D.
Title: PRESIDENT
Phone: (858) 453-3813
Address
Address
9834 Genesee Ave STE 326, La Jolla, CA 92037
National Provider ID: 1306355714
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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GARY VANDENBERG, JR., M.D., INC

9834 Genesee Ave #326, La Jolla, CA 92037

Registration:
Jul 22, 1976
State ID:
C0774547
Business type:
Articles of Incorporation
Presidents:
Vandenberg Gary (President),Gary Vandenberg President, inactive
Agent:
Gary Vandenberg, M.d,La Jolla, CA 92037 (Physical)

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