| Asim Guha Roy, M.d., Inc | |
| 
					4540 Kearny Villa Rd Ste 106 San Diego CA 92123-1564  | |
| (584) 306-6568 | |
| (858) 777-5632 | 
| Full Name | Asim Guha Roy, M.d., Inc | 
|---|---|
| Speciality | Internal Medicine | 
| Location | 4540 Kearny Villa Rd Ste 106, San Diego, California | 
| Authorized Official Name and Position | Asim Guha Roy (PRESIDENT) | 
| Authorized Official Contact | 8584306656 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Asim Guha Roy, M.d., Inc 8861 Villa La Jolla Dr # 13484 La Jolla CA 92037-1918 Ph: (858) 430-6656  | Asim Guha Roy, M.d., Inc 4540 Kearny Villa Rd Ste 106 San Diego CA 92123-1564 Ph: (584) 306-6568  | 
| NPI Number | 1578709515 | 
|---|---|
| Provider Enumeration Date | 12/22/2008 | 
| Last Update Date | 07/11/2019 | 
| Medicare PECOS PAC ID | 6305184110 | 
|---|---|
| Medicare Enrollment ID | O20190220001310 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1578709515 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary | 
| Provider Name | Asim Guha Roy | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1083659528 PECOS PAC ID: 9638196470 Enrollment ID: I20051031000692  | 
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