Provider Demographics
NPI:1922586114
Name:PRIMARY CARE ASSOCIATES OF CALIFORNIA OF SAN DIEGO, INC.
Entity Type:Organization
Organization Name:PRIMARY CARE ASSOCIATES OF CALIFORNIA OF SAN DIEGO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CLIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-561-4848
Mailing Address - Street 1:10833 VALLEY VIEW ST STE 570
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5061
Mailing Address - Country:US
Mailing Address - Phone:310-561-4848
Mailing Address - Fax:
Practice Address - Street 1:10833 VALLEY VIEW ST STE 570
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-5061
Practice Address - Country:US
Practice Address - Phone:310-561-4848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization