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Organization
MEDICAL GROUP OF NORTH COUNTY, INC.
Active
Organization
MEDICAL GROUP OF NORTH COUNTY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD L SMITH (COO/CFO)
(760) 598-1700
Entity
Organization
Contact information
Practice address
910 SYCAMORE AVE, SUITE 270, VISTA, CA 92081-7832
(760) 598-1700
(760) 598-1196
Mailing address
910 SYCAMORE AVE, SUITE 270, VISTA, CA 92081-7832
(760) 598-1700
(760) 598-1196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS9824
RAILROAD MEDICARE
CA
05
—
GR0051600
—
CA
05
—
LAB24971F
—
CA
01
—
ZZZ32969Z
BLUE SHIELD
CA
Enumeration date
07/11/2006
Last updated
11/30/2011
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