Provider Demographics
NPI:1215218748
Name:HHSA COUNTY OF SAN DIEGO
Entity Type:Organization
Organization Name:HHSA COUNTY OF SAN DIEGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH NURSE
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:COON
Authorized Official - Suffix:
Authorized Official - Credentials:PHN
Authorized Official - Phone:619-692-8293
Mailing Address - Street 1:3851 ROSECRANS ST
Mailing Address - Street 2:SUITE S (STD CLINIC)
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-3134
Mailing Address - Country:US
Mailing Address - Phone:619-692-8865
Mailing Address - Fax:619-692-8543
Practice Address - Street 1:3851 ROSECRANS ST
Practice Address - Street 2:SUITE S (STD CLINIC)
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-3134
Practice Address - Country:US
Practice Address - Phone:619-692-8865
Practice Address - Fax:619-692-8543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare