| Chula Vista Internal Medicine & Cardiology Medical Group | |
| 
					754 Medical Center Ct Ste 100 Chula Vista CA 91911  | |
| (619) 421-4000 | |
| (619) 421-6395 | 
| Full Name | Chula Vista Internal Medicine & Cardiology Medical Group | 
|---|---|
| Speciality | Internal Medicine | 
| Location | 754 Medical Center Ct, Chula Vista, California | 
| Authorized Official Name and Position | Elizabeth J Polkinghorne (OFFICE MANAGER) | 
| Authorized Official Contact | 6194214000 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Chula Vista Internal Medicine & Cardiology Medical Group 754 Medical Center Ct Ste 100 Chula Vista CA 91911 Ph: (619) 421-4000  | Chula Vista Internal Medicine & Cardiology Medical Group 754 Medical Center Ct Ste 100 Chula Vista CA 91911 Ph: (619) 421-4000  | 
| NPI Number | 1144348962 | 
|---|---|
| Provider Enumeration Date | 03/27/2007 | 
| Last Update Date | 09/26/2023 | 
| Medicare PECOS PAC ID | 1153389556 | 
|---|---|
| Medicare Enrollment ID | O20050103000263 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1144348962 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary | 
| Provider Name | David P Hansen | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1275647521 PECOS PAC ID: 3678531076 Enrollment ID: I20111213000715  | 
| Provider Name | Gregory T Czer | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1932218963 PECOS PAC ID: 0941268346 Enrollment ID: I20111215000162  | 
| Provider Name | Luis Daniel San Miguel | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1982088613 PECOS PAC ID: 8224339783 Enrollment ID: I20151229001019  | 
| Provider Name | Marco Martinez | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1922542182 PECOS PAC ID: 7911250725 Enrollment ID: I20181024002711  | 
Robert H Moon Md, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1030 White Alder Ave, Chula Vista, CA 91914 Phone: 619-800-6713 Fax: 619-503-9000  | |
Leticia Uwedjojevwe Md Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 340 4th Ave Ste 10, Chula Vista, CA 91910 Phone: 619-934-2215 Fax: 619-934-2340  | |
Family Health Centers Of San Diego Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 248 Landis Ave, Chula Vista, CA 91910 Phone: 619-515-2562 Fax: 619-269-0115  | |
Centro De Salud De La Comunidad De San Ysidro Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1061 Tierra Del Rey, Ste 303, 304, 305, Chula Vista, CA 91910 Phone: 619-662-4100  | |
Family Health Centers Of San Diego, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 264 Landis Ave Ste 100, Chula Vista, CA 91910 Phone: 619-906-5383 Fax: 619-237-1856  | |
Sharna B Shachar M D A Professional Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 525 H St, Chula Vista, CA 91910 Phone: 619-409-9999 Fax: 619-409-9905  | |
Operation Samahan Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 480 4th Ave Ste 401, Chula Vista, CA 91910 Phone: 844-200-2426 Fax: 619-356-2726  |