# CORE ORTHOPAEDIC MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** San Dieguito Orthopedic Medical Center PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306904180
- **Authorized official:** TOM DAWSON (CEO)
- **Authorized official phone:** (760) 632-4240

## Contact information

- **Practice address:** 332 SANTA FE DRIVE, STE 110, ENCINITAS, CA 92024
- **Practice address phone:** (760) 943-6700
- **Mailing address:** 332 SANTA FE DRIVE, STE 110, ENCINITAS, CA 92024
- **Mailing address phone:** (760) 943-6700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/05/2006
- **Last updated:** 08/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0093170 | — | CA |
| 01 | — | ZZZ04918Z | BLUE SHIELD | CA |