Provider Demographics
NPI:1750553772
Name:EAST MEETS WEST INTERNAL & PREVENTATIVE MEDICAL CENTER, APC
Entity type:Organization
Organization Name:EAST MEETS WEST INTERNAL & PREVENTATIVE MEDICAL CENTER, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:VERHOEVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-588-9355
Mailing Address - Street 1:PO BOX 21886
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-0968
Mailing Address - Country:US
Mailing Address - Phone:619-588-9355
Mailing Address - Fax:619-588-9335
Practice Address - Street 1:1240 BROADWAY
Practice Address - Street 2:201
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-4994
Practice Address - Country:US
Practice Address - Phone:619-588-9355
Practice Address - Fax:619-588-9335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45358207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABE666ZOtherMEDICARE INDIVIDUAL PIN
CABE666ZOtherMEDICARE INDIVIDUAL PIN
CAE91776Medicare UPIN
CABE666ZOtherMEDICARE INDIVIDUAL PIN