| Shelter Island Medical Group | |
|
1370 Rosecrans St Ste A San Diego CA 92106-2638 | |
| (619) 223-2668 | |
| (619) 223-2698 |
| Full Name | Shelter Island Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 1370 Rosecrans St, San Diego, California |
| Authorized Official Name and Position | Melanie A Mcintyre (OFFICE MANAGER) |
| Authorized Official Contact | 6192232668 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelter Island Medical Group 1370 Rosecrans St Ste A San Diego CA 92106-2638 Ph: (619) 223-2668 | Shelter Island Medical Group 1370 Rosecrans St Ste A San Diego CA 92106-2638 Ph: (619) 223-2668 |
| NPI Number | 1790886216 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 07/18/2023 |
| Medicare PECOS PAC ID | 6103860093 |
|---|---|
| Medicare Enrollment ID | O20230905003045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790886216 | NPI | - | NPPES |
| 1699015529 | Other | CA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | A32874 (California) | Primary |
| Provider Name | Andrew Nabil Saleh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699015529 PECOS PAC ID: 4183920028 Enrollment ID: I20161220002217 |
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