| Clancy Medical Group | |
|
2375 S Melrose Dr Vista CA 92081-8788 | |
| (760) 305-1900 | |
| (760) 305-1910 |
| Full Name | Clancy Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 2375 S Melrose Dr, Vista, California |
| Authorized Official Name and Position | John Harold Clancy (PRESIDENT) |
| Authorized Official Contact | 7603051900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clancy Medical Group 2375 S Melrose Dr Vista CA 92081-8788 Ph: (760) 305-1900 | Clancy Medical Group 2375 S Melrose Dr Vista CA 92081-8788 Ph: (760) 305-1900 |
| NPI Number | 1053722124 |
|---|---|
| Provider Enumeration Date | 05/12/2014 |
| Last Update Date | 11/19/2018 |
| Medicare PECOS PAC ID | 0547485419 |
|---|---|
| Medicare Enrollment ID | O20140709000697 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053722124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 9614 (California) | Primary |
| 208000000X | Pediatrics | 9695 (California) | Secondary |
| Provider Name | John H Clancy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962506238 PECOS PAC ID: 4284729591 Enrollment ID: I20141118000661 |
| Provider Name | Tara L Clancy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588086003 PECOS PAC ID: 1557588159 Enrollment ID: I20150106002075 |
| Provider Name | Shannon Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518191014 PECOS PAC ID: 1052674827 Enrollment ID: I20210317002290 |
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Ross Webster Chiropractic Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 850 East Vista Way, Suite A, Vista, CA 92084 Phone: 760-630-0426 Fax: 760-630-0456 | |
Cassidy Medical Group - Sw Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2095 W Vista Way Ste 218, Vista, CA 92083 Phone: 760-630-3562 Fax: 760-630-2559 | |
Vista Community Clinic - Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 Vale Terrace, Vista, CA 92084 Phone: 760-631-5000 | |
Centro De Salud De La Comunidad De San Ysidro, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1840 West Dr, Vista, CA 92083 Phone: 619-662-4100 | |
Amir Moradi, M.d., A. Prof. Corp. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2023 W Vista Way Ste F, Vista, CA 92083 Phone: 760-726-6451 Fax: 760-726-4822 |