CASSIDY MEDICAL GROUP - CSB (NPI# 1457427668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457427668 |
| Entity Type | Organization |
| Organization Name | CASSIDY MEDICAL GROUP - CSB |
| Practice Address |
2562 State St Ste D Carlsbad CA 92008-1663 |
| Practice Telephone | 7607297186 |
| Practice Fax Number | 7607292753 |
| Mailing Telephone | 7607297186 |
| Mailing Fax Number | 7607292753 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2008-03-14 |
| Authorized Official Name | JUDITH M KRUEGER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7606305487 |
| Is Organization Subpart | Y |
| Parent Organization Name | CASSIDY MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | NEIC SITE ID, NSF BA0-7 | 3023 | 01 |
| CA | GR0060603 | 05 |
| Street Address |
2562 STATE ST STE D |
| City | CARLSBAD |
| State | CA |
| Zip Code | 92008-1663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063585495 | Gary P Korff | Family Medicine | 2562 State St Ste D, Carlsbad, CA 92008-1663 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760029706 | Todd F Ovokaitys | Internal Medicine | 2260 Rutherford Road, Suite 101, C/o Gematria, Carlsbad, CA 92008 | 2019-12-10 |
| 1710548375 | San Diego Dental Anesthesia | Dentist | 1287 Carlsbad Village Drive, Carlsbad, CA 92008 | 2019-06-25 |
| 1972096717 | Toshiya Kawano | Chiropractor | 5650 El Camino Real Ste 285, Carlsbad, CA 92008 | 2018-06-06 |
| 1184111684 | Brittany Lauren Cheatham | Nurse Practitioner | 345 Walnut Ave, Carlsbad, CA 92008 | 2018-04-19 |
| 1770092843 | Michele Laporte Downey | Counselor | 2910 Jefferson St, Suite 100, Carsbad, CA 92008 | 2017-09-21 |
| 1225567142 | Shana Smith | Occupational Therapy Assistant | 5870 El Camino Real, Carlsbad, CA 92008 | 2017-06-05 |
| 1336690395 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 2559 Camino Real Rd, Carlsbad, CA 92008 | 2016-10-14 |
| 1093174849 | Nhi Thi Diem Nguyen | Pharmacist | 6850 Avenida Encinas, Carlsbad, CA 92008 | 2016-02-22 |
| 1912362112 | Brooke Ann Bellomio | Psychologist | 2558 Roosevelt St. Suite 203, Carlsbad, CA 92008 | 2015-12-15 |
| 1285005660 | Thanh-trinh Doan | Optometrist | 2322 Rutherford Rd., Carlsbad, CA 92008 | 2015-10-12 |
| Find all providers in zip 92008 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487973996 | Scripps Health | Clinic/Center | 2176 Salk Ave, Carlsbad, CA 92008-7346 | 2010-05-24 |
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| 1437767951 | Miro Health | Clinic/Center | 260 King St Unit 1505, San Francisco, CA 94107-6415 | 2020-07-21 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.