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ADVANCED CALIFORNIA MEDICAL CENTER INC. NPI 1962597807


NPI Information

NPI: 1962597807
Provider Name: ADVANCED CALIFORNIA MEDICAL CENTER, INC.

Doing Business As: ADVANCED CALIFORNIA MEDICAL CENTER, INC.

Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 05D1033022

Address:
10737 CAMINO RUIZ
SUITE 114
SAN DIEGO, CA
ZIP 92126
Phone: (858) 578-9600
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ADVANCED CALIFORNIA MEDICAL CENTER, INC. is an obstetrics gynecology in San Diego, CA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. ADVANCED CALIFORNIA MEDICAL CENTER, INC. NPI is 1962597807. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Advanced California Medical Center, Inc..

The provider's business location address is:

10737 CAMINO RUIZ
SUITE 114
SAN DIEGO, CA
ZIP 92126-359
Phone: (858) 578-9600
Fax: (858) 578-9065

The provider's authorized official is Deena S Tajran .
The authorized official title is Owner President and has the following contact phone number (858) 578-9600.

The CLIA number assigned to this NPI record is 05D1033022 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/4/2006 and was last updated on 7/20/2015.


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
1207R00000XInternal MedicineA55154CALIFORNIANo
2207V00000XObstetrics & GynecologyA55154CALIFORNIAYes

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
1ZZZ65931ZOTHERCALIFORNIABLUE SHIELD CA
2ZZZ65932ZOTHERCALIFORNIABLUE SHIELD CA
3H63479MEDICARE UPIN
400A551540MEDICAIDCALIFORNIA
5ZZZ65933ZOTHERCALIFORNIABLUE SHIELD CA
6774581OTHERBLUE SHIELD CA

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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