Organization
STANLEY D. SKAGGS, M.D. INC
Active
Organization
STANLEY D. SKAGGS, M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY D. SKAGGS M.D. (OWNER)
(858) 334-8656
Entity
Organization
Contact information
Practice address
12985 CLAYMONT CT, SAN DIEGO, CA 92130-2431
(858) 334-8656
Mailing address
12985 CLAYMONT CT, SAN DIEGO, CA 92130-2431
(858) 334-8656
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004125760
AETNA
—
01
—
00G392450
BLUE SHIELD OF CALIFORNIA
CA
05
—
00G392450
—
CA
01
—
3291421
CIGNA
—
01
—
DN730A
MEDICARE PTAN
CA
Enumeration date
07/17/2007
Last updated
09/14/2013
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