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Organization
CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF PATH
Active
Organization
CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF PATH
Active
Parent organization
CHILDREN'S SPECIALISTS OF SAN DIEGO
Other names
Children's Associated Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S SPECIALISTS OF SAN DIEGO
Authorized official
HERBERT C. KIMMONS JR. M.D. (CREDENTIALING)
(858) 966-8567
Entity
Organization
Contact information
Practice address
3020 CHILDRENS WAY, SAN DIEGO, CA 92123-4223
(858) 966-5944
Mailing address
3860 CALLE FORTUNADA, SUITE 210, SAN DIEGO, CA 92123-4800
(858) 309-6303
(858) 309-6301
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
—
NULL
207ZP0101X
Anatomic Pathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
207ZP0213X
Pediatric Pathology Physician
—
NULL
207ZP0213X
Pediatric Pathology Physician
—
—
Other
Enumeration date
01/03/2007
Last updated
04/22/2008
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