CASSIDY MEDICAL GROUP INC. (NPI# 1215003470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215003470 |
| Entity Type | Organization |
| Organization Name | CASSIDY MEDICAL GROUP INC. |
| Practice Address |
145 Thunder Dr Vista CA 92083-6010 |
| Practice Telephone | 7606305487 |
| Practice Fax Number | 7606302558 |
| Mailing Telephone | 7606305487 |
| Mailing Fax Number | 7606302558 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2010-06-09 |
| Authorized Official Name | JOHN M BENNETT (PRESIDENT) |
| Authorized Official Telephone | 7606305487 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| 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 | DEPARTMENT OF LABOR ID | 366026600 | 01 |
| CA | UNIVERSAL ID | CAME25 | 01 |
| CA | BLUE CROSS BLUE SHIELD ID | ZZZ59748Z | 01 |
| CA | GR0060600 | 05 | |
| CA | NEIC SITE ID, NSF BA0-7 | 3000 | 01 |
| Street Address |
145 THUNDER DR |
| City | VISTA |
| State | CA |
| Zip Code | 92083-6010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396855235 | Amad Edward Kadry | Family Medicine | 145 Thunder Dr, Vista, CA 92083-6010 | 2006-08-30 |
| 1790166858 | Talia M Adams | Physician Assistant | 145 Thunder Dr, 1st Floor, Vista, CA 92083-6010 | 2015-06-15 |
| 1053648626 | Deisha Malones Wilson | Family Medicine | 145 Thunder Dr, Vista, CA 92083-6010 | 2009-11-03 |
| 1770721714 | Regina Lynn Petersen | Physician Assistant | 145 Thunder Dr, Vista, CA 92083-6010 | 2009-01-29 |
| 1376723437 | Leo Russel Best | Physician Assistant | 145 Thunder Dr, Vista, CA 92083-6010 | 2007-11-06 |
| 1518184266 | Lily R Caesar | Physician Assistant | 145 Thunder Dr, Vista, CA 92083-6010 | 2007-04-20 |
| 1629295258 | David E Jones | Family Medicine | 145 Thunder Dr, Vista, CA 92083-6010 | 2007-04-18 |
| 1083781249 | Cassidy Medical Group - Radiology | Radiology | 145 Thunder Dr, Vista, CA 92083-6010 | 2006-11-30 |
| 1881761047 | Cassidy Medical Group - Ob-gyn | Obstetrics & Gynecology | 145 Thunder Dr, Vista, CA 92083-6010 | 2006-11-30 |
| 1295801470 | Erin C Quinn | Nurse Practitioner | 145 Thunder Dr, Vista, CA 92083-6010 | 2006-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114496882 | Claire Louise Marsden | Speech-Language Pathologist | 1626 Fawley Lane, Vista, CA 92083 | 2018-11-24 |
| 1861975336 | Shawna Corn | Counselor | 216 W. Los Angeles Dr., Vista, CA 92083 | 2018-09-11 |
| 1164916433 | Sindia Zamarripa | Case Manager/Care Coordinator | 139 East Dr, Vista, CA 92083 | 2018-06-19 |
| 1184140295 | Rosa Gema Pamatz | Counselor | 216 West Los Angeles Dr, Vista, CA 92083 | 2017-08-21 |
| 1528452521 | Vincetta Cox | Nursing Care | 770 Sycamore Avenue, 122-178, Vista, CA 92083 | 2015-03-27 |
| 1922367739 | Oriental Medical Arts & Acupuncture | Acupuncturist | 544 W Vista Way, Vista, CA 92083 | 2012-05-14 |
| 1861623001 | Dawn Lindshield | Counselor | 550 W Vista Way Ste 408, Vista, CA 92083 | 2009-08-06 |
| 1932336534 | Amyjane Dill | Student in an Organized Health Care Education/Training Program | 216 W Los Angeles Drive, New Haven Youth Family Services, Vista, CA 92083 | 2009-06-22 |
| 1821239054 | Marisela Wong | Pharmacist | 1510 N. Santa Fe Avenue, Vista, CA 92083 | 2009-03-18 |
| 1235389602 | Erik Sven Peterson | Counselor | 155 W. Bobier, Vista, CA 92083 | 2008-09-23 |
| Find all providers in zip 92083 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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|---|---|---|---|---|
| 1568844124 | Spinezone Mediical Fitness | Clinic/Center | 2301 S Melrose Dr, Vista, CA 92081-8788 | 2015-06-19 |
| 1124348024 | Scripps Health | Clinic/Center | 2067 W Vista Way, Vista, CA 92083-6031 | 2010-06-03 |
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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.