Organization
SAN DIEGO PROFESSIONAL GROUP, P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK CALARCO DO (FACILITY CEO)
(615) 712-5862
Entity
Organization
Contact information
Practice address
24552 PACIFIC PARK DR, ALISO VIEJO, CA 92656-3033
(615) 727-8416
(615) 457-8094
Mailing address
200 POWELL PL, ATTN: LEGAL DEPARTMENT, BRENTWOOD, TN 37027-7514
(615) 732-1605
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
20A6119
CA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
20A6119
CA
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
20A6119
CA
Other
Enumeration date
08/16/2016
Last updated
08/25/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us