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

## Provider details

- **NPI number:** 1669148813
- **Authorized official:** USAMA ALKAZAKI (OWNER)
- **Authorized official phone:** (619) 354-4694

## Contact information

- **Practice address:** 436 S MAGNOLIA AVE STE 201, EL CAJON, CA 92020-5237
- **Practice address phone:** (619) 704-3229
- **Mailing address:** 505 N MOLLISON AVE STE 103, EL CAJON, CA 92021-6159
- **Mailing address phone:** (619) 354-4694
- **Mailing address fax:** (619) 310-9709

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | Yes |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 08/18/2021
- **Last updated:** 04/20/2023