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Organization
CORE ORTHOPAEDIC MEDICAL CENTER
Active
Organization
CORE ORTHOPAEDIC MEDICAL CENTER
Active
Other names
San Dieguito Orthopedic Medical Center PC
Organization subpart
No
Provider details
NPI number
Authorized official
TOM DAWSON (CEO)
(760) 632-4240
Entity
Organization
Contact information
Practice address
332 SANTA FE DRIVE, STE 110, ENCINITAS, CA 92024
(760) 943-6700
Mailing address
332 SANTA FE DRIVE, STE 110, ENCINITAS, CA 92024
(760) 943-6700
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0093170
—
CA
01
—
ZZZ04918Z
BLUE SHIELD
CA
Enumeration date
12/05/2006
Last updated
08/08/2008
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