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Organization
PARK TERRACE MEDICAL ASSOCIATES INC
Active
Organization
PARK TERRACE MEDICAL ASSOCIATES INC
Active
Parent organization
YES
Other names
Centre For Healthcare
Organization subpart
Yes
Provider details
NPI number
Legal business name
YES
Authorized official
LAWRENCE ANDREW KOENIG M.D. (MEDICAL DIRECTOR)
(858) 613-8900
Entity
Organization
Contact information
Practice address
15611 POMERADO RD, SUITE 400, POWAY, CA 92064-2437
(858) 613-8900
(858) 618-1523
Mailing address
15611 POMERADO RD, SUITE 400, POWAY, CA 92064-2437
(858) 613-8900
(858) 618-1523
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
207K00000X
Allergy & Immunology Physician
—
—
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207YS0012X
Sleep Medicine (Otolaryngology) Physician
—
—
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
—
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
04/14/2009
Last updated
04/14/2009
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