| Genesee Medical Group Inc | |
|
7830 Clairemont Mesa Blvd Suite 100 San Diego CA 92111-1619 | |
| (858) 268-1111 | |
| (858) 268-0761 |
| Full Name | Genesee Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7830 Clairemont Mesa Blvd, San Diego, California |
| Authorized Official Name and Position | Donald P Tecca (OWNER) |
| Authorized Official Contact | 8582681111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesee Medical Group Inc 7830 Clairemont Mesa Blvd Suite 100 San Diego CA 92111-1619 Ph: (858) 268-1111 | Genesee Medical Group Inc 7830 Clairemont Mesa Blvd Suite 100 San Diego CA 92111-1619 Ph: (858) 268-1111 |
| NPI Number | 1043480320 |
|---|---|
| Provider Enumeration Date | 03/03/2008 |
| Last Update Date | 04/29/2020 |
| Medicare PECOS PAC ID | 1254325350 |
|---|---|
| Medicare Enrollment ID | O20050218000386 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043480320 | NPI | - | NPPES |
| WG45791A | Other | MEDICARE GROUP | |
| 0010860 | Other | CA | MEDICAID GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G45791 (California) | Primary |
| Provider Name | Arthur Anthony Blain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801816525 PECOS PAC ID: 7719972322 Enrollment ID: I20040414001735 |
| Provider Name | Jeffrey Dysart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154361558 PECOS PAC ID: 1052463700 Enrollment ID: I20090710000315 |
| Provider Name | Donald Tecca |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235163163 PECOS PAC ID: 5496707341 Enrollment ID: I20100210000263 |
| Provider Name | Mekrae Lauren Parsons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972090306 PECOS PAC ID: 5395095657 Enrollment ID: I20180906002741 |
| Provider Name | Mark Patrick Manning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417439647 PECOS PAC ID: 0749528107 Enrollment ID: I20190208002358 |
| Provider Name | Tam Kien Tran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245767037 PECOS PAC ID: 6305116286 Enrollment ID: I20200916002170 |
| Provider Name | Jaafar Al-dahwi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639551435 PECOS PAC ID: 7911250303 Enrollment ID: I20201214003207 |
| Provider Name | Summer Pillsbury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205526639 PECOS PAC ID: 0345695441 Enrollment ID: I20231010001578 |
| Provider Name | Lyndsey Jane Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699485664 PECOS PAC ID: 6709231848 Enrollment ID: I20231010003703 |
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