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Organization
PERSONAL PHYSICIANS GROUP, INC.
Active
Organization
PERSONAL PHYSICIANS GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VENU PRABAKER M.D. (PRESIDENT)
(619) 579-8681
Entity
Organization
Contact information
Practice address
1685 E MAIN ST, SUITE 202, EL CAJON, CA 92021-5225
(619) 579-8681
(619) 579-0759
Mailing address
1685 E MAIN ST, SUITE 202, EL CAJON, CA 92021-5225
(619) 579-8681
(619) 579-0759
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FNP 34594
FICTITIOUS NAME PERMIT
CA
Enumeration date
05/28/2006
Last updated
08/22/2020
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