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Mary F. Kodiath, NP
Adult Health Nurse Practitioner in San Diego, California
NPI 1891748026

Mary F. Kodiath is an Adult Health Nurse Practitioner based in Poway, CA and is specialized in Adult Health. Mary F. Kodiath practices in San Diego, CA and has the professional credentials of NP. The NPI Number for Mary F. Kodiath is 1891748026 and holds a License No. 366086 (California).

The current practice location address for Mary F. Kodiath is 3350 Lajolla Village Drive, San Diego, CA and can be reached out via phone at 858-552-8585.

Location: 3350 Lajolla Village Drive, San Diego, CA, 92064-3809
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1891748026
Provider Name
Mary F. Kodiath
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
3350 Lajolla Village Drive, San Diego, CA, 92064-3809
Phone Number
858-552-8585
Fax Number
Provider Enumeration Date
05/18/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
3350 Lajolla Village Drive
City
San Diego
State
California
Zip
92161-0001
Phone Number
858-552-8585
Fax Number
person
Provider Business Mailing Address Details
Address
3350 Lajolla Village Drive
City
San Diego
State
California
Zip
92161-0001
Phone Number
858-552-8585
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
363LA2200X
License No.
366086 (California)
Definition
Definition to come...
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