CIECAL RC INC NPI 1942659149

NPI Information

NPI: 1942659149
Provider Name: CIECAL RC INC
Classification: Clinic/Center - 261QP2300X
Specialization: Primary Care
Entity Type: Organization
Doing Business As: SOUTH BAY PRIMARY MEDICAL GROUP
CLIA Number: 05D2215838
Address: 769 MEDICAL CENTER CT
SUITE 303
CHULA VISTA, CA
ZIP 91911
Phone: (619) 591-9001

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NPI Details

CIECAL RC INC is a primary care clinic center in Chula Vista, CA. CIECAL RC INC NPI is 1942659149. The provider is registered as an organization entity type.
The provider Is Doing Business As South Bay Primary Medical Group.

The provider's business location address is:

769 MEDICAL CENTER CT
SUITE 303
CHULA VISTA, CA
ZIP 91911-602
Phone: (619) 591-9001
Fax: (619) 591-9211

The provider's authorized official is Tracy Lee Polanco .
The authorized official title is Owner/president and has the following contact phone number (619) 591-9001.

The CLIA number assigned to this NPI record is 05D2215838 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/8/2016 and was last updated on 11/16/2016.

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
1	261QP2300X	Clinic/Center	Primary Care	A76528	CALIFORNIA	No
2	261QP2300X	Clinic/Center	Primary Care	A80610	CALIFORNIA	Yes

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: 11/21/2025

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