Healthcare Provider Details

I. General information

NPI: 1457773608
Provider Name (Legal Business Name): IAN FINN M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2014
Last Update Date: 01/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12786 SALMON RIVER RD
SAN DIEGO CA
92129-3553
US

IV. Provider business mailing address

12786 SALMON RIVER RD
SAN DIEGO CA
92129-3553
US

V. Phone/Fax

Practice location:
  • Phone: 312-953-6880
  • Fax:
Mailing address:
  • Phone: 312-953-6880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License NumberA124367
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: