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SAN DIEGO PEDIATRICS & FAMILY MEDICAL CLINIC NPI 1265443444


NPI Information

NPI: 1265443444
Provider Name: SAN DIEGO PEDIATRICS & FAMILY MEDICAL CLINIC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 05D1056826

Address:
401 H ST
SUITE #3
CHULA VISTA, CA
ZIP 91910
Phone: (619) 691-0001
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SAN DIEGO PEDIATRICS & FAMILY MEDICAL CLINIC is a general practice in Chula Vista, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee SAN DIEGO PEDIATRICS & FAMILY MEDICAL CLINIC NPI is 1265443444. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

401 H ST
SUITE #3
CHULA VISTA, CA
ZIP 91910-321
Phone: (619) 691-0001
Fax: (619) 691-0111

The provider's authorized official is Mario Eduardo Eyzaguirre .
The authorized official title is Physician/ Ceo and has the following contact phone number (619) 691-0001.

The CLIA number assigned to this NPI record is 05D1056826 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/11/2006 and was last updated on 7/21/2022.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeA42572CALIFORNIAYes

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: 5/5/2024

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