Bayside Urology Medical Group INC
Specialist in Chula Vista, CA. Organization (NPI-2).
NPI number1164536579
StatusActive
Last updated in NPPESMay 10, 2011
Details
- NPI
- 1164536579
- Entity type
- Organization (NPI-2)
- Legal business name
- Bayside Urology Medical Group INC
- Organization subpart
- No
- Enumeration date
- Aug 19, 2006
- Last updated
- May 10, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
450 4th AveSte 303
Chula Vista, CA 91910-4429
Phone 619-420-0201 · Fax 619-425-7795
Mailing address
450 4th AveSte 303
Chula Vista, CA 91910-4429
Phone 619-420-0201 · Fax 619-425-7795
Authorized official
Daniel B. Hunting
Owner
6194200201
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