Provider Demographics
NPI:1760438592
Name:US HEALTHWORKS MEDICAL GROUP PC
Entity Type:Organization
Organization Name:US HEALTHWORKS MEDICAL GROUP PC
Other - Org Name:PRN PALOMAR AIRPORT PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:OKUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-565-1300
Mailing Address - Street 1:5575 RUFFIN ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1314
Mailing Address - Country:US
Mailing Address - Phone:858-565-1300
Mailing Address - Fax:858-565-6932
Practice Address - Street 1:5611 PALMER WAY
Practice Address - Street 2:SUITE A
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92008-7242
Practice Address - Country:US
Practice Address - Phone:760-603-9166
Practice Address - Fax:760-603-9161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ05334ZOtherBLUE SHIELD
CAB1O70BMedicare PIN
CAW14801Medicare PIN