MERCY VASCULAR, A PROFESSIONAL MEDICAL CORPORATION (NPI# 1306369798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306369798 |
| Entity Type | Organization |
| Organization Name | MERCY VASCULAR, A PROFESSIONAL MEDICAL CORPORATION |
| Practice Address |
550 Washington St Ste 641 San Diego CA 92103-2229 |
| Practice Telephone | (619) 299-2600 |
| Practice Fax Number | 6192993923 |
| Mailing Telephone | 6192992600 |
| Mailing Fax Number | 6192993923 |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | DR. JEFFREY SCOTT WEISS (OWNER) |
| Authorized Official Telephone | 6192992600 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4077 Fifth Ave, San Diego, CA 921032105 | 6192948111 |
| Street Address |
550 WASHINGTON ST STE 641 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-2229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760430417 | Matthew Jeffrey Martin | Surgery | 550 Washington St Ste 641, San Diego, CA 92103-2229 | 2006-05-05 |
| 1659416485 | Fakhri M. Salem | Specialist | 550 Washington St Ste 641, San Diego, CA 92103-2229 | 2007-02-20 |
| 1194889410 | Vishal Bansal | Surgery | 550 Washington St Ste 641, San Diego, CA 92103-2229 | 2006-12-21 |
| 1699833012 | Jeffrey Scott Weiss | Surgery | 550 Washington St Ste 641, San Diego, CA 92103-2229 | 2006-12-05 |
| 1215018403 | Kimberly A Peck | Surgery | 550 Washington St Ste 641, San Diego, CA 92103-2229 | 2006-10-17 |
| 1043310030 | Richard I Blum | Internal Medicine | 550 Washington St Ste 641, San Diego, CA 92103-2229 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265872873 | Sasha Salloum, Md, Inc | Surgery | 1250 Cleveland Ave, Suite A209, San Diego, CA 92103-7300 | 2013-06-27 |
| 1194097873 | David Roger James | Surgery | 577 Rosecrans St., San Diego, CA 92106-0000 | 2012-01-27 |
| 1316012339 | Huntington Beach Surgery | Surgery | 12828 Baywind Pt, San Diego, CA 92130-2796 | 2006-11-22 |
| 1639173974 | Bernard J Urlaub | Surgery | 5555 Reservoir Dr., Ste. 206, San Diego, CA 92120-5101 | 2005-06-01 |
| 1659503316 | Tazo Inui | Surgery | 3350 La Jolla Village Dr, San Diego, CA 92161-0002 | 2009-08-13 |
| 1902051311 | Bernard J. Urlaub, Md, Inc | Surgery | 6699 Alvarado Rd, Ste. 2210, San Diego, CA 92120-5238 | 2008-11-26 |
| 1164684056 | Kelley Deborah Hodgkiss-harlow | Surgery | 4647 Zion Ave, San Diego, CA 92120-2507 | 2008-07-01 |
| 1770742264 | Omar Al-nouri | Surgery | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2008-06-09 |
| 1912055971 | Timothy G. Canty Jr. | Surgery | 4647 Zion Ave, San Diego, CA 92120-2507 | 2007-01-08 |
| 1265591929 | Robert F. Mc Ginn | Surgery | 4647 Zion Ave, San Diego, CA 92120-2507 | 2006-12-08 |
| Find all providers in SAN DIEGO | ||||
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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.