| Chula Vista Internal Medicine & Cardiology Medical Group | |
|
754 Medical Center Ct Ste 100 Chula Vista CA 91911 | |
| (619) 421-4000 | |
| (619) 421-6395 |
| Full Name | Chula Vista Internal Medicine & Cardiology Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 754 Medical Center Ct, Chula Vista, California |
| Authorized Official Name and Position | Elizabeth J Polkinghorne (OFFICE MANAGER) |
| Authorized Official Contact | 6194214000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chula Vista Internal Medicine & Cardiology Medical Group 754 Medical Center Ct Ste 100 Chula Vista CA 91911 Ph: (619) 421-4000 | Chula Vista Internal Medicine & Cardiology Medical Group 754 Medical Center Ct Ste 100 Chula Vista CA 91911 Ph: (619) 421-4000 |
| NPI Number | 1144348962 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 09/26/2023 |
| Medicare PECOS PAC ID | 1153389556 |
|---|---|
| Medicare Enrollment ID | O20050103000263 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144348962 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | David P Hansen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275647521 PECOS PAC ID: 3678531076 Enrollment ID: I20111213000715 |
| Provider Name | Gregory T Czer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932218963 PECOS PAC ID: 0941268346 Enrollment ID: I20111215000162 |
| Provider Name | Luis Daniel San Miguel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982088613 PECOS PAC ID: 8224339783 Enrollment ID: I20151229001019 |
| Provider Name | Marco Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922542182 PECOS PAC ID: 7911250725 Enrollment ID: I20181024002711 |
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Landis Avenue Family Counseling Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 264 Landis Ave Ste 100, Chula Vista, CA 91910 Phone: 619-906-5383 Fax: 619-237-1856 | |
Sharna B Shachar M D A Professional Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 525 H St, Chula Vista, CA 91910 Phone: 619-409-9999 Fax: 619-409-9905 | |
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