Organization
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
Active
Other names
Target Clinic Medical Associates of Southern California
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMIN DAVIDOFF M.D. (EXECUTIVE MEDICAL DIRECTOR)
(877) 608-0044
Entity
Organization
Contact information
Practice address
1288 CAMINO DEL RIO N, SAN DIEGO, CA 92108-1511
(877) 608-0044
Mailing address
393 E WALNUT ST, PROVIDER ENROLLMENT, 3RD FLOOR, PASADENA, CA 91188-0001
(877) 608-0044
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
07/11/2014
Last updated
11/02/2021
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