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Organization
INDUSTRIAL CARE SPECIALIST
Active
Organization
INDUSTRIAL CARE SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHIE BACON (BILLING MANAGER)
(619) 202-6970
Entity
Organization
Contact information
Practice address
5565 GROSSMONT CENTER DR STE 259, LA MESA, CA 91942-3098
(619) 315-0336
(619) 315-0338
Mailing address
PO BOX 33, PORT HUENEME, CA 93044-0033
(619) 202-6970
(619) 202-6971
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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