Provider Demographics
NPI:1801253869
Name:PUBLIC HEALTH SERVICES-SAN DIEGO COUNTY
Entity type:Organization
Organization Name:PUBLIC HEALTH SERVICES-SAN DIEGO COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WILMA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WOOTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-542-4181
Mailing Address - Street 1:3851 ROSECRANS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-3115
Mailing Address - Country:US
Mailing Address - Phone:619-542-4181
Mailing Address - Fax:
Practice Address - Street 1:3851 ROSECRANS ST # 207
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-3115
Practice Address - Country:US
Practice Address - Phone:619-542-4181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH AND HUMAN SERVICES AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-21
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare