Du Quette, Mary Walch
Du Quette, Mary Walch is an individual health care provider with primary practice located at 2020 Genesee Ave , San Diego CA 92123-4219. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is her primary health care specialty. Du Quette, Mary Walch can be contacted via phone (858) 616-8100.Contact Information
Primary practice address
2020 Genesee Ave
San Diego CA 92123-4219
Phone: (858) 616-8100
Fax: (858) 569-5209
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | G70844 | California |
| Allopathic & Osteopathic Physicians / Pain Medicine | 2081P2900X | G70844 | California |
Profile Details
| NPI number | 1497765614 |
|---|---|
| LBN Legal business name | Du Quette, Mary Walch |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 9th, 2006 |
| Last updated | Jun 18th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497765614 | NPPES |
| California | MEDICAID | 00G708440 |
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