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General NPI Number Information
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NPI Number | 1972807683
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Entity Type | Individual
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Provider Name | AMADEO PESCE PHD
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Gender | Male
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Dates
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Enumeration Date | 01/10/2011
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 4215 SORRENTO VALLEY BLVD STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92121-1408
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Country | US
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Telephone | 800-635-6901
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Fax | 858-228-9909
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Provider Business Mailing Address
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Address Line | 6755 MIRA MESA BLVD STE 123-BOX 153
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City | SAN DIEGO
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State | CA
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Zip | 92121-4311
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Country | US
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Telephone | 800-635-6901
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Fax | 858-228-9909
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0104X
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Taxonomy Name | Chemical Pathology Physician
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License Number | DRI-100000098
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License Number State | CA
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