| San Diego Professional Group, P. C. | |
|
24552 Pacific Park Dr Aliso Viejo CA 92656-3033 | |
| (615) 727-8416 | |
| (615) 457-8094 |
| Full Name | San Diego Professional Group, P. C. |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Medicine |
| Location | 24552 Pacific Park Dr, Aliso Viejo, California |
| Authorized Official Name and Position | Mark Calarco (FACILITY CEO) |
| Authorized Official Contact | 6157125862 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Diego Professional Group, P. C. 200 Powell Pl Attn: Legal Department Brentwood TN 37027-7514 Ph: (615) 732-1605 | San Diego Professional Group, P. C. 24552 Pacific Park Dr Aliso Viejo CA 92656-3033 Ph: (615) 727-8416 |
| NPI Number | 1699220004 |
|---|---|
| Provider Enumeration Date | 08/16/2016 |
| Last Update Date | 08/25/2021 |
| Certification Date | 08/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699220004 | NPI | - | NPPES |
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