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NPI Code Detail

MEDICARE: DR. JOHN NMN CLEARY M.D.

MEDICARE: DR. JOHN NMN CLEARY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistCA

General Provider Information

NPI Number : 1265523740
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN NMN CLEARY M.D.
Provider Business Mailing Address
First Line : 7920 FROST ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-2736
Country : US
Telephone Number : 858-292-8911
Fax Number : 858-292-1115
Provider Business Practice Location Address
First Line : 7920 FROST ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-2736
Country : US
Telephone Number : 858-292-8911
Fax Number : 858-292-1115
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JOHN NMN CLEARY M.D.” Practice Location

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