Tyler Kent Short, MD
Radiology, Vascular & Interventional Radiology in San Diego, CA. Individual provider (NPI-1).
NPI number1669907192
StatusActive
Last updated in NPPESJun 1, 2024
Details
- NPI
- 1669907192
- Entity type
- Individual (NPI-1)
- Name
- Tyler Kent Short
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 21, 2017
- Certification date
- Jun 1, 2024
- Last updated
- Jun 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0204X | Radiology, Vascular & Interventional Radiology | 193406 | CA | Yes |
| 171000000X | Military Health Care Provider | – | – | |
| 2085R0202X | Radiology, Diagnostic Radiology | 193406 | CA |
Practice location
Naval Medical Ctr34800 Bob Wilson Dr
San Diego, CA 92134-0001
Phone 619-532-5998 · Fax 619-532-5507
Mailing address
Naval Medical Ctr34800 Bob Wilson Dr
San Diego, CA 92134-0001
Phone 619-532-5998 · Fax 619-532-5507
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