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1568059145
DEREK RUSSELL NYE
SAN DIEGO, CA
NPI
1568059145
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: CA 95206866)
Enumeration Date
2020-12-29
Last Update Date
2020-12-29
Business Address
DEREK RUSSELL NYE RN, PHN
3851 ROSECRANS ST STE 716
SAN DIEGO, CA 92110-3115
Phone number: 619-972-2432
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Mailing Address
DEREK RUSSELL NYE RN, PHN
3317 RIVIERA DR
SAN DIEGO, CA 92109-6614
Phone number: 619-201-0881
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