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KEARNY MESA MEDICAL GROUP NPI 1417075383


NPI Information

NPI: 1417075383
Provider Name: KEARNY MESA MEDICAL GROUP
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
7525 LINDA VISTA RD
SAN DIEGO, CA
ZIP 92111
Phone: (858) 277-2361
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KEARNY MESA MEDICAL GROUP is a family medicine in San Diego, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. KEARNY MESA MEDICAL GROUP NPI is 1417075383. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7525 LINDA VISTA RD
SAN DIEGO, CA
ZIP 92111-301
Phone: (858) 277-2361

The provider's authorized official is Noelle Blakely .
The authorized official title is Admin. and has the following contact phone number (858) 277-2361.

The enumeration date for this NPI number is 3/27/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineCALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR0040150MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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