| Kearny Mesa Medical Group | |
|
7525 Linda Vista Rd San Diego CA 92111-5301 | |
| (858) 277-2361 | |
| Not Available |
| Full Name | Kearny Mesa Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 7525 Linda Vista Rd, San Diego, California |
| Authorized Official Name and Position | Noelle Blakely (ADMIN.) |
| Authorized Official Contact | 8582772361 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kearny Mesa Medical Group 7525 Linda Vista Rd San Diego CA 92111-5301 Ph: () - | Kearny Mesa Medical Group 7525 Linda Vista Rd San Diego CA 92111-5301 Ph: (858) 277-2361 |
| NPI Number | 1417075383 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7113181876 |
|---|---|
| Medicare Enrollment ID | O20120607000737 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417075383 | NPI | - | NPPES |
| GR0040150 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (California) | Primary |
| Provider Name | Gary P Mcfeeters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790813962 PECOS PAC ID: 8921262684 Enrollment ID: I20120607000748 |
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