Provider Demographics
NPI:1457541633
Name:ACCESS MEDICAL CENTERS, A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ACCESS MEDICAL CENTERS, A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:ACCESS MEDICAL CENTERS, A PROFESSIONAL MEDICAL CORPORATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GORIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-729-2351
Mailing Address - Street 1:477 N. EL CAMINO REAL
Mailing Address - Street 2:SUITE A100
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024
Mailing Address - Country:US
Mailing Address - Phone:760-729-2351
Mailing Address - Fax:760-729-9675
Practice Address - Street 1:2626 EL CAMINO REAL STE B
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1253
Practice Address - Country:US
Practice Address - Phone:760-729-2351
Practice Address - Fax:760-729-9675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80982261QP2300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care