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1194121954
KELLIE JOHNSON MATUSALEM
SAN DIEGO, CA
NPI
1194121954
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Former Name
KELLIE JOHNSON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA 51956)
Enumeration Date
2014-11-06
Last Update Date
2021-12-21
Business Address
KELLIE JOHNSON MATUSALEM MS, PA-C
3750 CONVOY ST STE 201
SAN DIEGO, CA 92111-3770
Phone number: 858-278-8300
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Mailing Address
KELLIE JOHNSON MATUSALEM MS, PA-C
3750 CONVOY ST STE 201
SAN DIEGO, CA 92111-3770
Phone number: 858-278-8300
Copy
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