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Organization
NORTH COUNTY INTERNISTS MEDICAL CORPORATION
Active
Organization
NORTH COUNTY INTERNISTS MEDICAL CORPORATION
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
SCOTT PETERSON (CFO)
(858) 625-2990
Entity
Organization
Contact information
Practice address
15721 POMERADO RD, POWAY, CA 92064-2021
(858) 485-7454
Mailing address
9276 SCRANTON RD, SUITE 100, SAN DIEGO, CA 92121-7701
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
G24300
CA
Other
Enumeration date
02/12/2007
Last updated
01/13/2017
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