Provider Demographics
NPI:1407282544
Name:GOINS, GARY (RN)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:GOINS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10755 SCRIPPS POWAY PKWY # 560
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-3924
Mailing Address - Country:US
Mailing Address - Phone:907-227-0798
Mailing Address - Fax:
Practice Address - Street 1:10755 SCRIPPS POWAY PKWY # 560
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-3924
Practice Address - Country:US
Practice Address - Phone:907-227-0798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA493327163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency