| Medaid Center | |
|
5580 La Jolla Blvd Suite 611 La Jolla CA 92037-7651 | |
| (858) 405-9653 | |
| Not Available |
| Full Name | Medaid Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 5580 La Jolla Blvd, La Jolla, California |
| Authorized Official Name and Position | Mark C Henderson (CEO) |
| Authorized Official Contact | 8584059653 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medaid Center 5580 La Jolla Blvd Suite 611 La Jolla CA 92037-7651 Ph: () - | Medaid Center 5580 La Jolla Blvd Suite 611 La Jolla CA 92037-7651 Ph: (858) 405-9653 |
| NPI Number | 1508091307 |
|---|---|
| Provider Enumeration Date | 05/22/2009 |
| Last Update Date | 08/15/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508091307 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | C50464 (California) | Primary |
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