Provider Demographics
NPI:1346338449
Name:VELK, GENE MATTHEW (DDS)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:MATTHEW
Last Name:VELK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16810 BERNARDO CENTER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2543
Mailing Address - Country:US
Mailing Address - Phone:858-485-1123
Mailing Address - Fax:858-485-1085
Practice Address - Street 1:16810 BERNARDO CENTER DR
Practice Address - Street 2:SUITE A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2543
Practice Address - Country:US
Practice Address - Phone:858-485-1123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA219601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice