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Organization
PRISMA CARE, A MEDICAL CORPORATION
Active
Organization
PRISMA CARE, A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE R LOPEZ (PRESIDENT)
(619) 575-5000
Entity
Organization
Contact information
Practice address
2648 MAIN ST, SUITE #A, CHULA VISTA, CA 91911-4664
(619) 575-5000
(619) 575-5060
Mailing address
2648 MAIN ST, SUITE #A, CHULA VISTA, CA 91911-4664
(619) 575-5000
(619) 575-5060
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A43301
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A433010
—
CA
Enumeration date
10/03/2006
Last updated
07/15/2009
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