CASSIDY MEDICAL GROUP - OB-GYN NPI 1881761047

NPI Information

  • NPI: 1881761047
  • Provider Name: CASSIDY MEDICAL GROUP - OB-GYN
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Organization
  • Address: 145 THUNDER DR
    VISTA, CA
    ZIP 92083
  • Phone: (760) 941-1440

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NPI Details

CASSIDY MEDICAL GROUP - OB-GYN is an obstetrics gynecology in Vista, 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. CASSIDY MEDICAL GROUP - OB-GYN NPI is 1881761047. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

145 THUNDER DR
VISTA, CA
ZIP 92083-010
Phone: (760) 941-1440
Fax: (760) 630-5477

The provider's authorized official is Judith M Krueger .
The authorized official title is Executive Director and has the following contact phone number (760) 630-5487.

The enumeration date for this NPI number is 11/30/2006 and was last updated on 10/14/2010.

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
1207V00000XObstetrics & GynecologyYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13019OTHERCALIFORNIANEIC SITE ID, NSF BAO-7
2W14833MEDICARE PINCALIFORNIA
3GR0060601MEDICAIDCALIFORNIA
4CH4627MEDICARE PINCALIFORNIA

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: 3/30/2025

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