Kolodge, Gavin
Kolodge, Gavin is an sole proprietor health care provider with primary practice located at 9339 Genesee Ave Ste 150, San Diego CA 92121-2144. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Kolodge, Gavin can be contacted via phone (858) 357-9477.Contact Information
Primary practice address
9339 Genesee Ave Ste 150
San Diego CA 92121-2144
Phone: (858) 357-9477
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 2081P2900X | 20A18281 | California |
Profile Details
| NPI number | 1407210537 |
|---|---|
| LBN Legal business name | Kolodge, Gavin |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 5th, 2016 |
| Last updated | Sep 21st, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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