Eastlake Family Medical INC.
Family Medicine in Chula Vista, CA. Organization (NPI-2).
NPI number1124101985
StatusActive
Last updated in NPPESJun 5, 2014
Details
- NPI
- 1124101985
- Entity type
- Organization (NPI-2)
- Legal business name
- Eastlake Family Medical INC.
- Organization subpart
- No
- Enumeration date
- Oct 23, 2006
- Last updated
- Jun 5, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 20A 6433 | CA | Yes |
Other names
- Eastlake Family Medical INC. (Former Legal Business Name)
Practice location
2452 Fenton StreetSuite 301
Chula Vista, CA 91914
Phone 619-946-4073 · Fax 619-946-7243
Mailing address
2452 Fenton StreetSuite 301
Chula Vista, CA 91914
Phone 619-946-4073 · Fax 619-946-7243
Authorized official
Maria De Los Angeles Oseguera
President
6199464073
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