| Medicus Md Inc | |
|
3969 4th Ave Ste #203 San Diego CA 92103-3165 | |
| (619) 294-6500 | |
| (619) 294-6505 |
| Full Name | Medicus Md Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3969 4th Ave, San Diego, California |
| Authorized Official Name and Position | Barbara Denysiak (VICE PRESIDENT) |
| Authorized Official Contact | 6192946500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medicus Md Inc 3969 4th Ave Ste #203 San Diego CA 92103-3165 Ph: (619) 294-6500 | Medicus Md Inc 3969 4th Ave Ste #203 San Diego CA 92103-3165 Ph: (619) 294-6500 |
| NPI Number | 1427076009 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 09/08/2023 |
| Medicare PECOS PAC ID | 3375727555 |
|---|---|
| Medicare Enrollment ID | O20110413000121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427076009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A48505 (California) | Primary |
| Provider Name | Barbara Denysiak |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1003085572 PECOS PAC ID: 3577566900 Enrollment ID: I20060824000285 |
| Provider Name | Jacqueline Denysiak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902337827 PECOS PAC ID: 3476963604 Enrollment ID: I20201029001137 |
| Provider Name | Brian Paul Lantos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184094849 PECOS PAC ID: 2567756950 Enrollment ID: I20221018001350 |
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