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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