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Organization
SOCAL MEDICAL CLINICS
Active
Organization
SOCAL MEDICAL CLINICS
Active
Other names
REVIVE WOUND GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL GERSON MD (CEO)
(619) 241-2191
Entity
Organization
Contact information
Practice address
2878 CAMINO DEL RIO S STE 220, SAN DIEGO, CA 92108-3845
(619) 241-2191
Mailing address
2878 CAMINO DEL RIO S STE 220, SAN DIEGO, CA 92108-3845
(619) 241-2191
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
04/17/2025
Last updated
04/21/2025
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