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11838 Bernardo Plaza Ct Ste 110 San Diego CA 92128-2414 | |
| (858) 673-5437 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 11838 Bernardo Plaza Ct Ste 110, San Diego, California |
| Authorized Official Name and Position | Terra Rae Scott (SVP OUTPATIENT PEDIATRICS) |
| Authorized Official Contact | 3034374364 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
41769 Enterprise Cir N Ste 104-105 Temecula CA 92590-5626 Ph: (951) 303-8255 | 11838 Bernardo Plaza Ct Ste 110 San Diego CA 92128-2414 Ph: (858) 673-5437 |
| NPI Number | 1356013650 |
|---|---|
| Provider Enumeration Date | 10/05/2021 |
| Last Update Date | 06/27/2023 |
| Certification Date | 06/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356013650 | NPI | - | NPPES |
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