Provider Demographics
NPI:1629253505
Name:SENIOR MEDICAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:SENIOR MEDICAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:S
Authorized Official - Last Name:KERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-299-1419
Mailing Address - Street 1:2810 CAMINO DEL RIO S
Mailing Address - Street 2:STE 102
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3818
Mailing Address - Country:US
Mailing Address - Phone:619-299-1419
Mailing Address - Fax:858-461-6008
Practice Address - Street 1:2810 CAMINO DEL RIO S
Practice Address - Street 2:STE 102
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3818
Practice Address - Country:US
Practice Address - Phone:858-385-1419
Practice Address - Fax:858-461-6008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty