| John Videen Md,inc | |
|
752 Medical Center Ct Suite 210 Chula Vista CA 91911-6658 | |
| (619) 421-3361 | |
| (619) 656-8936 |
| Full Name | John Videen Md,inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 752 Medical Center Ct, Chula Vista, California |
| Authorized Official Name and Position | Teresa Reyes (OFFICE MANAGER) |
| Authorized Official Contact | 6193169142 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John Videen Md,inc Po Box 121957 Chula Vista CA 91912-6657 Ph: (619) 421-3361 | John Videen Md,inc 752 Medical Center Ct Suite 210 Chula Vista CA 91911-6658 Ph: (619) 421-3361 |
| NPI Number | 1891893848 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 11/01/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891893848 | NPI | - | NPPES |
| 00G592710 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G59271 (California) | Primary |
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