| Centro Medico Del Carmen, A Medical Corporation | |
|
303 S Juniper St Escondido CA 92025-4924 | |
| (760) 480-9051 | |
| (760) 480-9054 |
| Full Name | Centro Medico Del Carmen, A Medical Corporation |
|---|---|
| Speciality | General Practice |
| Location | 303 S Juniper St, Escondido, California |
| Authorized Official Name and Position | Thomas Lee Watson (CEO) |
| Authorized Official Contact | 7604809051 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro Medico Del Carmen, A Medical Corporation 303 S Juniper St Escondido CA 92025-4924 Ph: (760) 480-9051 | Centro Medico Del Carmen, A Medical Corporation 303 S Juniper St Escondido CA 92025-4924 Ph: (760) 480-9051 |
| NPI Number | 1063621738 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 01/22/2024 |
| Medicare PECOS PAC ID | 7416964580 |
|---|---|
| Medicare Enrollment ID | O20060314000710 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063621738 | NPI | - | NPPES |
| 00A521930 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A52193 (California) | Primary |
| Provider Name | Thomas L Watson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1104865781 PECOS PAC ID: 8022049386 Enrollment ID: I20050825001042 |
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