# SAN DIEGO PROFESSIONAL GROUP, P. C.

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

## Provider details

- **NPI number:** 1699220004
- **Authorized official:** MARK CALARCO DO (FACILITY CEO)
- **Authorized official phone:** (615) 712-5862

## Contact information

- **Practice address:** 24552 PACIFIC PARK DR, ALISO VIEJO, CA 92656-3033
- **Practice address phone:** (615) 727-8416
- **Practice address fax:** (615) 457-8094
- **Mailing address:** 200 POWELL PL, ATTN: LEGAL DEPARTMENT, BRENTWOOD, TN 37027-7514
- **Mailing address phone:** (615) 732-1605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | 20A6119 | CA | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | 20A6119 | CA | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | 20A6119 | CA | Yes |

## Other

- **Enumeration date:** 08/16/2016
- **Last updated:** 08/25/2021