Provider Demographics
NPI:1245344514
Name:ARCE, JORGE T (MD)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:T
Last Name:ARCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 4TH AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-4412
Mailing Address - Country:US
Mailing Address - Phone:619-422-2000
Mailing Address - Fax:619-422-2961
Practice Address - Street 1:480 4TH AVE STE 211
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-4412
Practice Address - Country:US
Practice Address - Phone:619-422-2000
Practice Address - Fax:619-422-2961
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35391207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A353910Medicaid
WA35391AMedicare ID - Type Unspecified
A84767Medicare UPIN