Organization
CORE ORTHOPAEDIC MEDICAL CENTER
Active
Other names
San Dieguito Orthopedic Medical Center PC
Organization subpart
No
Provider details
NPI number
Authorized official
TOM DAWSON (CEO)
(760) 632-4240
Entity
Organization
Contact information
Practice address
332 SANTA FE DRIVE, STE 110, ENCINITAS, CA 92024
(760) 943-6700
Mailing address
332 SANTA FE DRIVE, STE 110, ENCINITAS, CA 92024
(760) 943-6700
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0093170
—
CA
01
—
ZZZ04918Z
BLUE SHIELD
CA
Enumeration date
12/05/2006
Last updated
08/08/2008
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