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Organization
LAS PALMAS MEDICAL GROUP
Active
Organization
LAS PALMAS MEDICAL GROUP
Active
Other names
Valley Immediate Care
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS MENA (OFFICE MANAGER)
(760) 480-4747
Entity
Organization
Contact information
Practice address
1540 E VALLEY PKWY, ESCONDIDO, CA 92027-2316
(760) 621-4902
(760) 400-0012
Mailing address
1540 E VALLEY PKWY, ESCONDIDO, CA 92027-2316
(760) 621-4902
(760) 400-0012
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G57022
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164503652
—
CA
05
—
1770663551
—
CA
Enumeration date
02/09/2011
Last updated
02/14/2011
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