Provider Demographics
NPI:1891767182
Name:KINSELLA, MARY JO (DO, FACOG)
Entity Type:Individual
Prefix:DR
First Name:MARY JO
Middle Name:
Last Name:KINSELLA
Suffix:
Gender:F
Credentials:DO, FACOG
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Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:NMSCD, ATTN: MEDICAL STAFF SERVICES
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-1098
Mailing Address - Country:US
Mailing Address - Phone:619-532-6460
Mailing Address - Fax:619-532-6299
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:NMSCD, ATTN: MEDICAL STAFF SERVICES
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1098
Practice Address - Country:US
Practice Address - Phone:619-532-6460
Practice Address - Fax:619-532-6587
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2021-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A8308207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology