Organization
CHILDRENS HEALTHCARE MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN H CARSON M.D. (PRESIDENT)
(619) 297-5437
Entity
Organization
Contact information
Practice address
550 WASHINGTON ST, SUITE 300, SAN DIEGO, CA 92103-2213
(619) 237-5437
(619) 243-0722
Mailing address
550 WASHINGTON ST, SUITE 300, SAN DIEGO, CA 92103-2213
(619) 237-5437
(619) 243-0722
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G393080
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BLUE SHIELD
ZZZ02551Z
CA
05
—
GR0045532
—
CA
Enumeration date
08/23/2006
Last updated
01/31/2012
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