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General NPI Number Information
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NPI Number | 1710089313
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Entity Type | Organization
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Legal Business Name | BERTHA GEE-LEW MD FAAP INC
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2850 6TH AVE
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City | SAN DIEGO
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State | CA
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Zip | 92103-6308
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Country | US
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Telephone | 619-295-3911
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Fax | 619-295-4356
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Provider Business Mailing Address
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Address Line | 2850 6TH AVE
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City | SAN DIEGO
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State | CA
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Zip | 92103-6308
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Country | US
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Telephone | 619-295-3911
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Fax | 619-295-4356
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | BERTHA MEI GEE-LEW
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Credential | M.D.
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Telephone | 619-295-3911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | G38238
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License Number State | CA
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