Organization
CASSIDY MEDICAL GROUP - CSB
Active
Parent organization
CASSIDY MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
CASSIDY MEDICAL GROUP
Authorized official
JUDITH M KRUEGER (EXECUTIVE DIRECTOR)
(760) 630-5487
Entity
Organization
Contact information
Practice address
2562 STATE ST STE D, CARLSBAD, CA 92008-1663
(760) 729-7186
(760) 729-2753
Mailing address
2562 STATE ST STE D, CARLSBAD, CA 92008-1663
(760) 729-7186
(760) 729-2753
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3023
NEIC SITE ID, NSF BA0-7
CA
05
—
GR0060603
—
CA
Enumeration date
11/28/2006
Last updated
03/14/2008
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