Provider Demographics
NPI:1013129238
Name:STRONG, PAMELA M
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:M
Last Name:STRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:HARRIEL
Other - Last Name:WALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4060 32ND ST
Mailing Address - Street 2:# 7
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-2082
Mailing Address - Country:US
Mailing Address - Phone:619-521-8507
Mailing Address - Fax:
Practice Address - Street 1:3211 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-4424
Practice Address - Country:US
Practice Address - Phone:619-683-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator