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Organization
PACIFIC PARADISE EMERGENCY PHYSICIANS MEDICAL GROUP INC
Active
Organization
PACIFIC PARADISE EMERGENCY PHYSICIANS MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL J. MANOS D.O. (PRESIDENT)
(626) 447-0296
Entity
Organization
Contact information
Practice address
2400 E 4TH ST, NATIONAL CITY, CA 91950-2026
(619) 470-4141
Mailing address
PO BOX 509015, DEPARTMENT # WS248, SAN DIEGO, CA 92150-9015
(626) 447-0296
(626) 447-6057
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780066076
MEDI-CAL
CA
Enumeration date
06/23/2015
Last updated
06/27/2016
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