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GASTRIC BANDING MEDICAL GROUP INC NPI 1841675386


NPI Information

NPI: 1841675386
Provider Name: GASTRIC BANDING MEDICAL GROUP INC

Doing Business As: AMBULATORY CARE MEDICAL GROUP

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
8705 COMPLEX DR
SAN DIEGO, CA
ZIP 92123
Phone: (858) 715-1822
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GASTRIC BANDING MEDICAL GROUP INC is a specialist in San Diego, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. GASTRIC BANDING MEDICAL GROUP INC NPI is 1841675386. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Ambulatory Care Medical Group.

The provider's business location address is:

8705 COMPLEX DR
SAN DIEGO, CA
ZIP 92123-401
Phone: (858) 715-1822
Fax: (858) 974-7245

The provider's authorized official is Ronald Leroy Gertsch .
The authorized official title is Medical Director and has the following contact phone number (858) 715-1822.

The enumeration date for this NPI number is 7/27/2015 and was last updated on 7/27/2015.


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
1174400000XSpecialistA35980CALIFORNIANo
2174400000XSpecialistA67078CALIFORNIANo
3174400000XSpecialistC35744CALIFORNIAYes

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
11043356033OTHERNPI
21124080015OTHERNPI
31891877056OTHERNPI

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: 11/14/2023

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