| Impact Medical Associates California | |
|
11838 Bernardo Plaza Ct Ste 260a San Diego CA 92128-2413 | |
| (858) 487-8778 | |
| (858) 487-2738 |
| Full Name | Impact Medical Associates California |
|---|---|
| Speciality | Family Medicine |
| Location | 11838 Bernardo Plaza Ct Ste 260a, San Diego, California |
| Authorized Official Name and Position | Michael Connelly (MANAGING PARTNER) |
| Authorized Official Contact | 7149059503 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Medical Associates California 2889 W Ashton Blvd Ste 175 Lehi UT 84043-6439 Ph: (584) 878-7788 | Impact Medical Associates California 11838 Bernardo Plaza Ct Ste 260a San Diego CA 92128-2413 Ph: (858) 487-8778 |
| NPI Number | 1609501006 |
|---|---|
| Provider Enumeration Date | 07/19/2022 |
| Last Update Date | 07/19/2022 |
| Medicare PECOS PAC ID | 3274902267 |
|---|---|
| Medicare Enrollment ID | O20221214001231 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609501006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jose Castrejon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568486710 PECOS PAC ID: 2062605405 Enrollment ID: I20101019000308 |
| Provider Name | Mary Nganga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578920880 PECOS PAC ID: 1759653827 Enrollment ID: I20220118000962 |
| Provider Name | Airene Maldonado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245972835 PECOS PAC ID: 8628458668 Enrollment ID: I20220707002582 |
| Provider Name | Amy Fowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407432933 PECOS PAC ID: 9234547779 Enrollment ID: I20250113002881 |
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