Organization
CLINICA MEDICA PEDIATRICA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO E EYZAGUIRRE MD (DIRECTOR)
(619) 264-2591
Entity
Organization
Contact information
Practice address
3802 NATIONAL AVE, SAN DIEGO, CA 92113-3223
(619) 264-2591
Mailing address
3802 NATIONAL AVE, SAN DIEGO, CA 92113-3223
(619) 264-2591
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
A42572
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A425720
—
CA
Enumeration date
11/20/2007
Last updated
11/20/2007
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