- Medicare Primary Care in San Diego, CA

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is a medicare enrolled primary clinic (Clinic/center - Urgent Care) in San Diego, California. The current practice location for is 5671 Balboa Ave, San Diego, California. For appointments, you can reach them via phone at (858) 800-2880. The mailing address for is 750 Otay Lakes Rd # 272, Chula Vista, California and phone number is (855) 362-9773.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1558788620. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (858) 800-2880.

Contact Information

5671 Balboa Ave
San Diego
CA 92111-2705
(858) 800-2880
(619) 569-2590

Map and Direction


Primary Care Clinic Profile

Full Name
SpecialityClinic/Center
Location5671 Balboa Ave, San Diego, California
Authorized Official Name and PositionDaniel Lareaux (MEDICAL DIRECTOR)
Authorized Official Contact8553629773
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

750 Otay Lakes Rd # 272
Chula Vista
CA 91910-6915

Ph: (855) 362-9773
5671 Balboa Ave
San Diego
CA 92111-2705

Ph: (858) 800-2880

NPI Details:

NPI Number1558788620
Provider Enumeration Date03/26/2014
Last Update Date07/16/2024

Medicare PECOS Information:

Medicare PECOS PAC ID8921225830
Medicare Enrollment IDO20140815001327

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1558788620NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QP2300XClinic/center - Primary Care (* (Not Available))Secondary
261QU0200XClinic/center - Urgent Care (* (Not Available))Primary
261QX0100XClinic/center - Occupational Medicine (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameLisa M Sacco
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144358938
PECOS PAC ID: 0749203958
Enrollment ID: I20060112001062
Provider NameJulie A Keeler
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1912963109
PECOS PAC ID: 7315963113
Enrollment ID: I20080306000514
Provider NameLuzviminda D Saidro
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1750364386
PECOS PAC ID: 0244291599
Enrollment ID: I20081112000017
Provider NameJennifer Doumas
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1124038328
PECOS PAC ID: 9739363920
Enrollment ID: I20110817000425
Provider NameJulie Elana Kaltgrad
Provider TypePractitioner - Preventive Medicine
Provider IdentifiersNPI Number: 1235444068
PECOS PAC ID: 9739354242
Enrollment ID: I20111212000938
Provider NameVicki Lynn Love
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699759134
PECOS PAC ID: 7517123110
Enrollment ID: I20120726000323
Provider NameCharles M Brown
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053762005
PECOS PAC ID: 8628356466
Enrollment ID: I20161028000596
Provider NameBrandy Gallagher
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114476769
PECOS PAC ID: 5698055937
Enrollment ID: I20161202001969
Provider NameCristiana Golu
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1083684997
PECOS PAC ID: 6608013990
Enrollment ID: I20171011001094
Provider NameXavier Jeremiah Ernst
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780010595
PECOS PAC ID: 2961631239
Enrollment ID: I20171117003130
Provider NameAaron J Stirling
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588142533
PECOS PAC ID: 1052663317
Enrollment ID: I20181015002143
Provider NameRowena San Juan Dacanay-herman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144689175
PECOS PAC ID: 6709110059
Enrollment ID: I20190620002357
Provider NameMackenzie L Williams
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629581764
PECOS PAC ID: 0345663134
Enrollment ID: I20200713002227
Provider NameMariusz Niedzwiecki
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083281679
PECOS PAC ID: 7719378504
Enrollment ID: I20220105002600
Provider NameAlba Casco
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689066490
PECOS PAC ID: 3870988413
Enrollment ID: I20220318000304
Provider NameChristina Braunworth
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831794023
PECOS PAC ID: 5294114203
Enrollment ID: I20220622002122
Provider NameMalinda Anderson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326542424
PECOS PAC ID: 0143584383
Enrollment ID: I20221012003010
Provider NameErika Trujillo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396462917
PECOS PAC ID: 5698145092
Enrollment ID: I20221229001387
Provider NameRenea Barrientos
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689333940
PECOS PAC ID: 7517339039
Enrollment ID: I20230209003174
Provider NameRegina J Garcia
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639673858
PECOS PAC ID: 7416208137
Enrollment ID: I20230410000766
Provider NameMichelle Brower
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588367668
PECOS PAC ID: 9537525118
Enrollment ID: I20230524002224
Provider NameDaniel Owen Lareaux
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1629606173
PECOS PAC ID: 7517380546
Enrollment ID: I20230622002992
Provider NamePhilip Krause
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1942735295
PECOS PAC ID: 6507215266
Enrollment ID: I20231207001005
Provider NameRahel A Demessie
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619749041
PECOS PAC ID: 6901255587
Enrollment ID: I20231207002058
Provider NameMichelle Wilcox
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194418012
PECOS PAC ID: 1557704806
Enrollment ID: I20240204000131
Provider NameSherlita Aguilar
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205522083
PECOS PAC ID: 4981041969
Enrollment ID: I20240326003142
Provider NameDonna Lagda Mather
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790243699
PECOS PAC ID: 0941742936
Enrollment ID: I20240605002948
Provider NameClarisa Pelayo Du
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528784345
PECOS PAC ID: 2062954894
Enrollment ID: I20240609000012
Provider NameNaomi Twigg
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689203838
PECOS PAC ID: 4789002676
Enrollment ID: I20240618001572
Provider NameEmily Torres Beltran
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811751712
PECOS PAC ID: 2668917451
Enrollment ID: I20240717000671
Provider NameAutumn Sunshine Houston
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881454726
PECOS PAC ID: 5991241085
Enrollment ID: I20240725000862

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.