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1760147656
BLAYNE MICHAEL VIDRINE
LA JOLLA, CA
NPI
1760147656
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
246ZS0410X Specialist/Technologist, Other Surgical Technologist
Enumeration Date
2021-11-04
Last Update Date
2021-11-04
Business Address
BLAYNE MICHAEL VIDRINE
9850 GENESEE AVE STE 210
LA JOLLA, CA 92037-1206
Phone number: 858-535-1075
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Mailing Address
BLAYNE MICHAEL VIDRINE
9850 GENESEE AVE STE 210
LA JOLLA, CA 92037-1206
Phone number: 858-535-1075
Copy
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