CABLE STREET FAMILY PRACTICE AND MEDICAL GROUP INC. NPI 1184834012

NPI Information

CABLE STREET FAMILY PRACTICE AND MEDICAL GROUP, INC. is a primary care clinic center in San Diego, CA. CABLE STREET FAMILY PRACTICE AND MEDICAL GROUP, INC. NPI is 1184834012. The provider is registered as an organization entity type.

The provider's business location address is:

1808 CABLE ST
SAN DIEGO, CA
ZIP 92107-103
Phone: (619) 221-4490
Fax: (619) 221-4494

The provider's authorized official is Noli A Cava .
The authorized official title is Medical Director and has the following contact phone number (619) 221-4490.

The CLIA number assigned to this NPI record is 05D0960721 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/22/2007 and was last updated on 12/21/2015.

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:

Other Identifiers

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

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