| Legacy Medical Group, Inc. | |
|
292 Euclid Ave Ste 210 San Diego CA 92114-3629 | |
| (619) 262-2224 | |
| Not Available |
| Full Name | Legacy Medical Group, Inc. |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 292 Euclid Ave Ste 210, San Diego, California |
| Authorized Official Name and Position | Ralph Hernandez (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6197335192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Medical Group, Inc. 292 Euclid Ave Ste 210 San Diego CA 92114-3629 Ph: () - | Legacy Medical Group, Inc. 292 Euclid Ave Ste 210 San Diego CA 92114-3629 Ph: (619) 262-2224 |
| NPI Number | 1083112247 |
|---|---|
| Provider Enumeration Date | 01/23/2018 |
| Last Update Date | 02/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083112247 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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