REJUVENATE MEDICAL GROUP INC (NPI# 1629626981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629626981 |
| Entity Type | Organization |
| Organization Name | REJUVENATE MEDICAL GROUP INC |
| Practice Address |
5030 Camino De La Siesta Ste 404 San Diego CA 92108-3120 |
| Practice Telephone | 6192959791 |
| Practice Fax Number | 6192976901 |
| Mailing Telephone | 6192959791 |
| Mailing Fax Number | 6192976901 |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2019-08-29 |
| Authorized Official Name | JESIKA CASEY (CFO) |
| Authorized Official Telephone | 6192959791 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
5030 CAMINO DE LA SIESTA STE 404 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92108-3120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902801 | Keri Castaneda | Behavior Technician | 025 Camino Del Rio South Suite 101, San Diego, CA 92108 | 2020-11-06 |
| 1457963738 | Diyana Giorgees | Case Manager/Care Coordinator | 5005 Texas Street, St. 203, San Diego, CA 92108 | 2020-08-19 |
| 1780211896 | Lori Mildred Jerman | Marriage & Family Therapist | Healthy Minds Counseling Services, 1455 Frazee Road, Suite 880, San Diego, CA 92108 | 2020-03-26 |
| 1285260737 | Demetrius Anderson | Counselor | Telecare Corporation Ihot, 1660 Hotel Circle North, Suite 101, San Deigo, CA 92108 | 2020-03-17 |
| 1033742465 | Dasc Medical Inc | Durable Medical Equipment & Medical Supplies | 5520 Gill Village Way, 907, San Diego, CA 92108 | 2020-02-13 |
| 1508401092 | Chanda Denee Kizer | Marriage & Family Therapist | 3517 Camino Del Rio N, Suite 407, San Diego, CA 92108 | 2019-11-08 |
| 1225695562 | Jenna Rose Shurer | Nurse Practitioner | 5030 Camino De La Siesla Ste 106, San Diego, CA 92108 | 2019-05-22 |
| 1952967812 | Martha Kebede Mekonen | Chiropractor | 2667 Camino Del Rio South, Suite #313, San Diego, CA 92108 | 2019-05-16 |
| 1053886135 | Andrea Jiselly Munoz | Behavior Technician | 3505 Camino Del Rio South, Suite 200, San Diego, CA 92108 | 2018-10-04 |
| 1386128916 | Sarah Elisabeth Smith | Counselor | 7575 Metropolitan Dr., San Diego, CA 92108 | 2018-09-19 |
| Find all providers in zip 92108 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316553530 | Kimberly Ann Callaway | General Practice | 4893 Drakewood Ter, San Diego, CA 92130-1406 | 2020-09-22 |
| 1114484573 | Revive Medical of San Diego | General Practice | 7220 Trade St Ste 209, San Diego, CA 92121-2326 | 2019-02-21 |
| 1144790643 | Elaine Esguerra | General Practice | 751 Kentmere Ter, San Diego, CA 92154-8415 | 2018-11-28 |
| 1609350909 | Cristina Lavenant Gordon | General Practice | 10912 Derrydown Way, San Diego, CA 92130-2897 | 2018-09-21 |
| 1144723289 | Andrew T Bagby | General Practice | 601 Mc Cain Blvd, San Diego, CA 92135 | 2018-03-15 |
| 1568828671 | Ceferina Pulgar Ruiz | General Practice | 6809 Freed Manor Lane, San Diego, CA 92114 | 2016-01-05 |
| 1578941597 | Zenus Joe Wilson | General Practice | 2446 Trident Way Bldg 637, San Diego, CA 92155-5494 | 2015-05-11 |
| 1457761090 | David Lilienfeld | General Practice | 13412 Pantera Rd, San Diego, CA 92130-1022 | 2014-05-05 |
| 1972920882 | Genevieve Dowling | General Practice | 5575 Ruffin Rd # 100us, San Diego, CA 92123-1380 | 2014-03-28 |
| 1316376361 | George Lawrence Hody | General Practice | 6120 Caminito Baeza, San Diego, CA 92122-3407 | 2013-11-09 |
| 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.