Provider Demographics
NPI:1922263714
Name:SAN DIEGO PULMONARY AND CRITICAL CARE MEDICAL GROUP INC.
Entity Type:Organization
Organization Name:SAN DIEGO PULMONARY AND CRITICAL CARE MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:LICHTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-299-2570
Mailing Address - Street 1:4033 3RD AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2138
Mailing Address - Country:US
Mailing Address - Phone:619-299-2570
Mailing Address - Fax:619-294-2738
Practice Address - Street 1:4033 3RD AVE STE 300
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2138
Practice Address - Country:US
Practice Address - Phone:619-299-2570
Practice Address - Fax:619-294-2738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty