Organization
POWAY MEDICAL CLINIC, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID THYGESON (CHIEF FINANCIAL OFFICER)
(858) 486-9100
Entity
Organization
Contact information
Practice address
13525 MIDLAND RD, POWAY, CA 92064-4771
(858) 486-9100
(858) 486-9101
Mailing address
13525 MIDLAND RD, POWAY, CA 92064-4771
(858) 486-9100
(858) 486-9101
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/16/2009
Last updated
10/16/2009
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