| Artemis Medical Group, Inc. | |
|
770 Washington St Suite 200 San Diego CA 92103-2209 | |
| (858) 278-3636 | |
| (858) 278-3637 |
| Full Name | Artemis Medical Group, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 770 Washington St, San Diego, California |
| Authorized Official Name and Position | Vishaal Mehra (PRESIDENT) |
| Authorized Official Contact | 8582783647 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Artemis Medical Group, Inc. 770 Washington St Suite 200 San Diego CA 92103-2209 Ph: (858) 278-3636 | Artemis Medical Group, Inc. 770 Washington St Suite 200 San Diego CA 92103-2209 Ph: (858) 278-3636 |
| NPI Number | 1144644170 |
|---|---|
| Provider Enumeration Date | 02/11/2014 |
| Last Update Date | 11/05/2015 |
| Medicare PECOS PAC ID | 0042534315 |
|---|---|
| Medicare Enrollment ID | O20150114001018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144644170 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | A67412 (California) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Eric M Chavez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902813157 PECOS PAC ID: 3173414836 Enrollment ID: I20040324000647 |
| Provider Name | Emily Genessa Samuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639549447 PECOS PAC ID: 2062702368 Enrollment ID: I20160527000351 |
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