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1508901810
MARY K. WILDE
LA JOLLA, CA
NPI
1508901810
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: CA G65602)
Enumeration Date
2007-02-21
Last Update Date
2007-11-28
Business Address
-- MARY K. WILDE MD
9850 GENESEE AVE STE 510
LA JOLLA, CA 92037-1213
Phone number: 858-623-2345
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Mailing Address
-- MARY K. WILDE MD
9850 GENESEE AVE STE 510
LA JOLLA, CA 92037-1213
Phone number: 858-623-2345
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