| Caring Hearts Medical Clinic | |
|
2401 Reo Dr San Diego CA 92139-3025 | |
| (619) 479-6767 | |
| (619) 434-8840 |
| Full Name | Caring Hearts Medical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 2401 Reo Dr, San Diego, California |
| Authorized Official Name and Position | Iyabo O Daramola (PRESIDENT) |
| Authorized Official Contact | 6194796767 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caring Hearts Medical Clinic Po Box 675833 Rancho Santa Fe CA 92067-5833 Ph: (619) 479-6767 | Caring Hearts Medical Clinic 2401 Reo Dr San Diego CA 92139-3025 Ph: (619) 479-6767 |
| NPI Number | 1114938214 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 09/06/2013 |
| Medicare PECOS PAC ID | 3779537543 |
|---|---|
| Medicare Enrollment ID | O20050304000599 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114938214 | NPI | - | NPPES |
| GR0098920 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A63633 (California) | Primary |
| Provider Name | Iyabo O Daramola |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851378236 PECOS PAC ID: 1153374400 Enrollment ID: I20050225000705 |
| Provider Name | Kenneth Campos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538385109 PECOS PAC ID: 5991844995 Enrollment ID: I20091204000313 |
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