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Organization
SOUTH BAY FAMILY MEDICAL GROUP, INC
Active
Organization
SOUTH BAY FAMILY MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EFRAIN T VALLADOLID SR. M.D. (PRESIDENT)
(619) 420-1378
Entity
Organization
Contact information
Practice address
584 E ST, CHULA VISTA, CA 91910-2348
(619) 420-1378
(619) 420-1331
Mailing address
584 E ST, CHULA VISTA, CA 91910-2348
(619) 420-1378
(619) 420-1331
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A61474
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A614740
—
CA
Enumeration date
12/20/2006
Last updated
03/02/2011
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