Organization
CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF CVS
Active
Parent organization
CHILDREN'S SPECIALISTS OF SAN DIEGO
Other names
Children's Associated Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S SPECIALISTS OF SAN DIEGO
Authorized official
HERBERT C. KIMMONS JR. M.D. (PRESIDENT)
(858) 966-8567
Entity
Organization
Contact information
Practice address
3030 CHILDRENS WAY, SUITE 202, SAN DIEGO, CA 92123-4232
(858) 966-8030
Mailing address
3860 CALLE FORTUNADA, SUITE 210, SAN DIEGO, CA 92123-4800
(858) 309-6303
(858) 309-6301
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR006886K
—
CA
Enumeration date
01/02/2007
Last updated
04/22/2008
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