Organization
SAN DIEGO VITREORETINAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH TERENCE DALY MD (PRESIDENT)
(858) 457-4090
Entity
Organization
Contact information
Practice address
9834 GENESEE AVENUE, SUITE 315, LA JOLLA, CA 92037-1221
(858) 457-4090
(858) 457-1543
Mailing address
9834 GENESEE AVENUE, SUITE 315, LA JOLLA, CA 92037-1221
(858) 457-4090
(858) 457-1543
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G26296
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180032742
RAILROAD MEDICARE
—
05
—
GR006892
—
CA
05
—
GR0068980
—
CA
01
—
GR0068981
MEDI CAL
CA
05
—
GR0068981
—
CA
01
—
GR0068982
MEDI CAL
CA
01
—
GR0068983
MEDI CAL
CA
05
—
GR0068983
—
CA
01
—
ZZZ55528Z
BLUE SHIELD
CA
01
—
ZZZ61560Z
BLUE SHIELD
CA
Enumeration date
09/26/2006
Last updated
08/19/2008
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