Tanner Gustavsen is a student in an organized health care education training program in San Diego, CA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Tanner Gustavsen NPI is 1952978082. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
4077 FIFTH AVE # MER-35
SAN DIEGO, CA
ZIP 92103-105
Phone: (208) 272-1194
The enumeration date for this NPI number is 6/8/2021 and was last updated on 3/28/2023.