Organization
SAN DIEGO REGIONAL P.E.T. CENTER, LLC
Active
Organization
SAN DIEGO REGIONAL P.E.T. CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM CLEARY (MANAGER)
(858) 499-0230
Entity
Organization
Contact information
Practice address
7625 MESA COLLEGE DR, 102, SAN DIEGO, CA 92111-5343
(858) 499-0230
(858) 499-0231
Mailing address
PO BOX 910026, SAN DIEGO, CA 92191-0026
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207U00000X
Nuclear Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ08027
BLUE SHIELD
—
Enumeration date
05/19/2006
Last updated
09/11/2025
Update your record
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