| St. Paul's Pace | |
|
111 Elm St San Diego CA 92101-2692 | |
| (619) 677-3800 | |
| (619) 781-8186 |
| Full Name | St. Paul's Pace |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 111 Elm St, San Diego, California |
| Authorized Official Name and Position | Amanda Joy Gois (MARKETING DIRECTOR) |
| Authorized Official Contact | 6196773800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Paul's Pace 111 Elm St San Diego CA 92101-2692 Ph: (619) 677-3800 | St. Paul's Pace 111 Elm St San Diego CA 92101-2692 Ph: (619) 677-3800 |
| NPI Number | 1386987915 |
|---|---|
| Provider Enumeration Date | 04/02/2013 |
| Last Update Date | 04/02/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386987915 | NPI | - | NPPES |
| 057 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 550001964 (California) | Primary |
| 305R00000X | Preferred Provider Organization | (California) | Secondary |
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