# CHILDREN'S PHYSICIANS MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659419505
- **Authorized official:** MS. BOBBI GOMEZ (DIRECTOR - MANAGED CARE)
- **Authorized official phone:** (858) 309-6280

## Contact information

- **Practice address:** 3860 CALLE FORTUNADA, SUITE 210, SAN DIEGO, CA 92123-4800
- **Practice address phone:** (858) 309-6270
- **Practice address fax:** (858) 309-6272
- **Mailing address:** 3860 CALLE FORTUNADA, SUITE 210, SAN DIEGO, CA 92123-4800
- **Mailing address phone:** (858) 309-6270
- **Mailing address fax:** (858) 309-6272

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 02/02/2007
- **Last updated:** 08/22/2020