# GATEWAY COMPREHENSIVE MEDICAL GROUP

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

## Provider details

- **NPI number:** 1831490184
- **Authorized official:** TAREK HASSANEIN M.D. (DIRECTOR)
- **Authorized official phone:** (619) 990-1698

## Contact information

- **Practice address:** 995 GATEWAY CENTER WAY, SUITE 105, SAN DIEGO, CA 92102-4500
- **Practice address phone:** (619) 264-1934
- **Mailing address:** PO BOX 181770, CORONADO, CA 92178-1770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A54452 | CA | Yes |

## Other

- **Enumeration date:** 11/03/2010
- **Last updated:** 04/29/2015