Organization
CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF MAT&FET
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
8010 FROST ST, SUITE 300, SAN DIEGO, CA 92123-2778
(858) 939-6880
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
207V00000X
Obstetrics & Gynecology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0068860
—
CA
Enumeration date
01/03/2007
Last updated
04/22/2008
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