Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JERRY WILLIAM SAN DIEGO, M.D.
ActiveDR. JERRY WILLIAM SAN DIEGO, M.D. is a Anatomic Pathology & Clinical Pathology healthcare provider located in LEAVENWORTH, Kansas. NPI 1285694604 is currently active in the NPPES registry. Verify at CMS.
Anatomic Pathology & Clinical Pathology · LEAVENWORTH, KS
Registration Details
- NPI Number
- 1285694604
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 28, 2006 (20.426561571632 yrs)
- Last Updated
- Aug 4, 2014
- License
-
024399 (LA)
Practice Information
- Address
-
4101 S 4TH STP AND LMSLEAVENWORTH, KS, 660485014Browse KS providers · Browse ZIP 66048
- Phone
- 9136822000
- Fax
- 9137584193
- Primary Specialty
-
Anatomic Pathology & Clinical Pathology
207ZP0102X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.