Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 27115 | CA |
Y | 213EG0000X | General Practice | 27115 | CA |
NPI | 1003238866 |
---|---|
Provider Name | Mr. Gregory M Culton |
First Address | National City, CA 91950-3628 |
Second Address | National City, CA 91950-3628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2014 |
Last Update Date | 14/01/2014 |