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Organization
JOHN VIDEEN MD,INC
Active
Organization
JOHN VIDEEN MD,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA REYES (OFFICE MANAGER)
(619) 316-9142
Entity
Organization
Contact information
Practice address
752 MEDICAL CENTER CT, SUITE 210, CHULA VISTA, CA 91911-6658
(619) 421-3361
(619) 656-8936
Mailing address
PO BOX 121957, CHULA VISTA, CA 91912-6657
(619) 421-3361
(619) 656-8936
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G59271
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G592710
—
CA
Enumeration date
09/20/2006
Last updated
11/01/2010
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