Organization
CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF EMER
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
3020 CHILDRENS WAY, SAN DIEGO, CA 92123-4223
(858) 966-8800
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
207P00000X
Emergency Medicine Physician
—
—
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0068864
—
CA
Enumeration date
12/19/2006
Last updated
04/22/2008
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