| Passport Health | |
|
11650 Iberia Place Suite 110 San Diego CA 92128-2406 | |
| (619) 295-5326 | |
| (877) 877-6875 |
| Full Name | Passport Health |
|---|---|
| Speciality | Clinic/center |
| Location | 11650 Iberia Place, San Diego, California |
| Authorized Official Name and Position | Paul Fishburn (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 4806469020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Passport Health 668 N 44th St Suite 100w Phoenix AZ 85008-6507 Ph: (877) 358-8646 | Passport Health 11650 Iberia Place Suite 110 San Diego CA 92128-2406 Ph: (619) 295-5326 |
| NPI Number | 1346659638 |
|---|---|
| Provider Enumeration Date | 08/12/2014 |
| Last Update Date | 05/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346659638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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