| Myezmed | |
|
6458 Fischer Way San Diego CA 92130-5804 | |
| (619) 823-1947 | |
| Not Available |
| Full Name | Myezmed |
|---|---|
| Speciality | Family Medicine |
| Location | 6458 Fischer Way, San Diego, California |
| Authorized Official Name and Position | Guillermo Castillo (CEO) |
| Authorized Official Contact | 6198231947 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Myezmed 553 N Pacific Coast Hwy Ste B-105 Redondo Beach CA 90277-2163 Ph: (310) 850-6279 | Myezmed 6458 Fischer Way San Diego CA 92130-5804 Ph: (619) 823-1947 |
| NPI Number | 1982441341 |
|---|---|
| Provider Enumeration Date | 07/12/2024 |
| Last Update Date | 07/12/2024 |
| Medicare PECOS PAC ID | 3072030758 |
|---|---|
| Medicare Enrollment ID | O20250506002558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982441341 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Shabana Haxton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750958633 PECOS PAC ID: 7911394531 Enrollment ID: I20220429001651 |
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