Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | G81223 | CA |
NPI | 1447319017 |
---|---|
Provider Name | Guy A. Ravad |
First Address | San Diego, CA 92120-2507 |
Second Address | San Diego, CA 92120-2507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 22/11/2021 |