Organization
SYCUAN TRIBAL GOVERNMENT
Active
Parent organization
SYCUAN TRIBAL GOVERNMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
SYCUAN TRIBAL GOVERNMENT
Authorized official
MAURICE SMITH (EXECUTIVE DIRECTOR)
(619) 445-0707
Entity
Organization
Contact information
Practice address
4921 DEHESA RD, EL CAJON, CA 92019-2929
(619) 445-0707
(619) 445-0901
Mailing address
4921 DEHESA RD, EL CAJON, CA 92019-2929
(619) 445-0707
(619) 445-0901
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427197078
—
CA
01
—
54220ZZZ50681Z
BLUE SHIELD OF CALIFORNIA
CA
05
—
THP70066F
—
CA
01
—
ZZZ50681Z
BLUE CROSS
CA
Enumeration date
02/06/2007
Last updated
02/13/2026
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