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General NPI Number Information
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NPI Number | 1932200367
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Entity Type | Organization
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Legal Business Name | SAN DIEGO VITREORETINAL ASSOCIATES
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 9834 GENESEE AVENUE SUITE 315
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City | LA JOLLA
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State | CA
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Zip | 92037-1221
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Country | US
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Telephone | 858-457-4090
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Fax | 858-457-1543
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Provider Business Mailing Address
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Address Line | 9834 GENESEE AVENUE SUITE 315
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City | LA JOLLA
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State | CA
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Zip | 92037-1221
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Country | US
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Telephone | 858-457-4090
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Fax | 858-457-1543
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH TERENCE DALY
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Credential | MD
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Telephone | 858-457-4090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G26296
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License Number State |
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