Provider Demographics
NPI:1154837466
Name:INSITE DIGESTIVE HEALTH CARE
Entity Type:Organization
Organization Name:INSITE DIGESTIVE HEALTH CARE
Other - Org Name:INSITE DIGESTIVE HEALTH CARE - DALY CITY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF CLINICAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOAQUIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-937-0275
Mailing Address - Street 1:1010 N CENTRAL AVE STE 380
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2937
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1850 SULLIVAN AVE STE 520
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2204
Practice Address - Country:US
Practice Address - Phone:650-756-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INSITE DIGESTIVE HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty