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Organization
SOUTH BAY GERIATRIC AND INTERNAL MEDICINE INC
Active
Organization
SOUTH BAY GERIATRIC AND INTERNAL MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MUSHRIK KAISEY MD (PRESIDENT)
(619) 426-9731
Entity
Organization
Contact information
Practice address
340 4TH AVE, #9, CHULA VISTA, CA 91910-3813
(619) 426-9731
(619) 426-9733
Mailing address
PO BOX 92191, SAN DIEGO, CA 92191-0723
(619) 426-9731
(619) 426-9733
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
A72963
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A729631
—
CA
Enumeration date
01/31/2011
Last updated
08/02/2011
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