Provider Demographics
NPI:1669838041
Name:COMPREHENSIVE PHYSICAL MEDICINE
Entity Type:Organization
Organization Name:COMPREHENSIVE PHYSICAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:1619-869-8900
Mailing Address - Street 1:875 G ST UNIT 704
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-6463
Mailing Address - Country:US
Mailing Address - Phone:619-318-3458
Mailing Address - Fax:619-869-8902
Practice Address - Street 1:816 PASEO DEL REY
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-7835
Practice Address - Country:US
Practice Address - Phone:619-869-8900
Practice Address - Fax:619-869-8902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty