Provider Demographics
NPI:1306404330
Name:PHYSICIANS HEALTH INSTITUTE
Entity Type:Organization
Organization Name:PHYSICIANS HEALTH INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRRESA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCIANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-240-7775
Mailing Address - Street 1:550 WASHINGTON ST STE 331
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2227
Mailing Address - Country:US
Mailing Address - Phone:619-297-5437
Mailing Address - Fax:
Practice Address - Street 1:550 WASHINGTON ST STE 331
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2227
Practice Address - Country:US
Practice Address - Phone:619-297-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty