# PEDIATRIC PRIMARY CARE ASSOCIATED MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356631972
- **Authorized official:** DR. STEPHEN H CARSON M.D. (PRESIDENT)
- **Authorized official phone:** (619) 757-1468

## Contact information

- **Practice address:** 550 WASHINGTON ST, STE 300, SAN DIEGO, CA 92103-2213
- **Practice address phone:** (619) 757-1468
- **Practice address fax:** (619) 243-0722
- **Mailing address:** 550 WASHINGTON ST, STE 300, SAN DIEGO, CA 92103-2213
- **Mailing address phone:** (619) 757-1468
- **Mailing address fax:** (619) 243-0722

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | G393080 | CA | Yes |

## Other

- **Enumeration date:** 04/15/2011
- **Last updated:** 04/15/2011