Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 20A6253 | CA |
NPI | 1023006418 |
---|---|
Provider Name | Gregg Garner |
First Address | San Diego, CA 92103-3746 |
Second Address | San Diego, CA 92103-3746 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2005 |
Last Update Date | 11/08/2009 |