Tanner Gustavsen

NPI #1952978082 in La Jolla, California

Provider Information

NPI Number: 1952978082
Entity Type: Individual
Name: Tanner Gustavsen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jun 8, 2021
Last Updated: Jun 20, 2024

Practice Location

Address: 9500 GILMAN DR
City: La Jolla
State: California
ZIP Code: 92093-2105
Phone: (858) 534-2230

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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