Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | A63645 | CA |
NPI | 1134258148 |
---|---|
Provider Name | Ms. Ildiko Christine Gerbatsch-Bornemisza |
First Address | San Diego, CA 92154-1664 |
Second Address | San Diego, CA 92154-1664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 15/12/2015 |