| Advanced California Medical Center, Inc. | |
|
10737 Camino Ruiz Suite 114 San Diego CA 92126-2359 | |
| (858) 578-9600 | |
| (858) 578-9065 |
| Full Name | Advanced California Medical Center, Inc. |
|---|---|
| Speciality | Obstetrics & Gynecology |
| Location | 10737 Camino Ruiz, San Diego, California |
| Authorized Official Name and Position | Deena S Tajran (OWNER PRESIDENT) |
| Authorized Official Contact | 8585789600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced California Medical Center, Inc. 1934 Via Casa Alta La Jolla CA 92037-5730 Ph: (858) 578-9600 | Advanced California Medical Center, Inc. 10737 Camino Ruiz Suite 114 San Diego CA 92126-2359 Ph: (858) 578-9600 |
| NPI Number | 1962597807 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 07/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962597807 | NPI | - | NPPES |
| ZZZ65932Z | Other | CA | BLUE SHIELD CA |
| ZZZ65933Z | Other | CA | BLUE SHIELD CA |
| 774581 | Other | BLUE SHIELD CA | |
| 00A551540 | Medicaid | CA | |
| ZZZ65931Z | Other | CA | BLUE SHIELD CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A55154 (California) | Secondary |
| 207V00000X | Obstetrics & Gynecology | A55154 (California) | Primary |
Stephen M. Daquino, Do; Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16445 Bernardo Center Dr, San Diego, CA 92128 Phone: 858-429-0099 Fax: 858-676-1172 | |
Nucleus Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4570 Executive Dr Ste 100, San Diego, CA 92121 Phone: 844-838-3322 | |
Moden Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8901 Activity Rd Ste 205, San Diego, CA 92126 Phone: 888-822-1184 Fax: 888-877-3676 | |
Aldiwani Medical Group Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11409 Windy Summit Pl, San Diego, CA 92127 Phone: 832-371-3279 Fax: 619-939-4556 | |
Azam Md & Mcjunkin Prof Corp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3455 Ingraham St, San Diego, CA 92109 Phone: 619-937-2055 | |
Presidio Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4440 Lamont St, San Diego, CA 92109 Phone: 858-270-7633 Fax: 858-270-7692 | |
Michael L Butera Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6699 Alvarado Rd Ste 2309, San Diego, CA 92120 Phone: 619-286-8803 Fax: 619-286-2344 |