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3020 Childrens Way # 5002 San Diego CA 92123-4223 | |
| (858) 576-1700 | |
| (858) 966-4051 |
| Full Name | |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 3020 Childrens Way # 5002, San Diego, California |
| Authorized Official Name and Position | Michael Hester (SR. DIRECTOR, REVENUE CYCLE APPLIC) |
| Authorized Official Contact | 8589666779 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3020 Childrens Way Mail Code 5002 San Diego CA 92123-4223 Ph: (858) 966-1700 | 3020 Childrens Way # 5002 San Diego CA 92123-4223 Ph: (858) 576-1700 |
| NPI Number | 1710065933 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 01/23/2025 |
| Medicare PECOS PAC ID | 3971677493 |
|---|---|
| Medicare Enrollment ID | O20080801000161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710065933 | NPI | - | NPPES |
| CGP165365 | Medicaid | CA | |
| 053303 | Other | CA | PINNACLE CLAIMS MANAGEMENT |
| ZZZH3702Z | Other | CA | BLUE SHIELD OF CA |
| 053303 | Other | CA | BLUE CROSS OF CALIFORNIA |
| 053303 | Other | CA | GIC INDEMNITY PLAN |
| CGP000355 | Medicaid | CA | |
| ZZT40271F | Medicaid | CA | |
| 053303 | Other | CA | WESTERN GROWERS |
| HSC30271F | Medicaid | CA | |
| 53125301 | Medicaid | HI | |
| ZZT30271F | Medicaid | CA |
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