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Organization
PSYCHIATRIC CONSULTANTS OF SAN DIEGO MEDICAL GROUP INC
Active
Organization
PSYCHIATRIC CONSULTANTS OF SAN DIEGO MEDICAL GROUP INC
Active
Other names
Raymond A. Fidaleo, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND A. FIDALEO M.D. (OWNER)
(858) 694-8399
Entity
Organization
Contact information
Practice address
7850 VISTA HILL AVE, SAN DIEGO, CA 92123-2717
(838) 694-8399
Mailing address
PO BOX 34190, SAN DIEGO, CA 92163-4190
(619) 680-4211
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G11749
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G117490
—
CA
Enumeration date
11/20/2007
Last updated
05/28/2009
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