Organization
UMANSKY MEDICAL MANAGEMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM S. UMANSKY MD (OWNER)
(858) 550-9697
Entity
Organization
Contact information
Practice address
4150 REGENTS PARK ROW, SIUTE #260, LA JOLLA, CA 92037-9124
(858) 550-9697
(858) 550-9698
Mailing address
4150 REGENTS PARK ROW, SIUTE #260, LA JOLLA, CA 92037-9124
(858) 550-9697
(858) 550-9698
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568716728
GROUP NPI
CA
01
—
1619048261
INDIVIDUAL NPI
CA
01
—
GX766Z
MEDICARE INDIVIDUAL PTAN
CA
Enumeration date
05/19/2015
Last updated
05/19/2015
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