Mondragon, Gustavo Arturo

Mondragon, Gustavo Arturo is an sole proprietor health care provider with primary practice located at 480 Fourth Ave Ste 500 , Chula Vista CA 91910-4414. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Mondragon, Gustavo Arturo can be contacted via phone (619) 656-5252.

Contact Information

Primary practice address
480 Fourth Ave Ste 500 Chula Vista CA 91910-4414
Phone: (619) 656-5252
Fax: (619) 656-5250
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X A40640 California

Profile Details

NPI number 1619080041
LBN Legal business name Mondragon, Gustavo Arturo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 17th, 2006
Last updated Aug 26th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1619080041 NPPES
California MEDICAID 00A406400

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