OCEAN BEACH MEDICAL GROUP (NPI# 1699032938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699032938 |
| Entity Type | Organization |
| Organization Name | OCEAN BEACH MEDICAL GROUP |
| Practice Address |
1947 Cable St San Diego CA 92107-2807 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 6192237164 |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2012-10-25 |
| Authorized Official Name | KENNY HEINE (SR DIRECTOR OPS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | G19279 | CA | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992710826 | Ocean Beach Medical Group | Family Medicine | 1947 Cable St, San Diego, CA 92107-2807 | 2006-07-29 |
| Street Address |
1947 CABLE ST |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92107-2807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649263682 | Jeoffry Bruce Gordon | Family Medicine | 1947 Cable St, San Diego, CA 92107-2807 | 2005-08-24 |
| 1992710826 | Ocean Beach Medical Group | Family Medicine | 1947 Cable St, San Diego, CA 92107-2807 | 2006-07-29 |
| 1609845700 | John Schiller Gillick | Anesthesiology | 1947 Cable St, San Diego, CA 92107-2807 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497111322 | Amanda Malicki | Occupational Therapist | 1567 Ocean Front St, San Diego, CA 92107 | 2016-01-07 |
| 1841689031 | Shari Houser | Marriage & Family Therapist | 1969 Sunset Cliffs Blvd, San Diego, CA 92107 | 2015-01-12 |
| 1740627868 | Marie Catherine Dumas | Psychologist | 3863 Coronado Ave, San Diego, CA 92107 | 2013-05-30 |
| 1386914422 | South Bay Internal Medicine and Family Practice | Non-Pharmacy Dispensing Site | 374 H Street, 202, San Diego, CA 92107 | 2012-01-06 |
| 1396023982 | Brooke Michelle Nielsen | Marriage & Family Therapist | 312 S. Cedros Ave. Ste 334, Ste. 304, Solana Beach, CA 92107 | 2011-07-29 |
| 1871890889 | Elizabeth Cantori | Occupational Therapist | 1865 1/2 Ebers St, San Diego, CA 92107 | 2011-02-28 |
| 1861716482 | Dina Chalom | Physical Therapist | 4833 Pescadero Ave Apt 3, San Diego, CA 92107 | 2010-03-25 |
| 1265762983 | David A. Schein | Psychiatry & Neurology | 4517 Newport Avenue, San Diego, CA 92107 | 2009-12-31 |
| 1184836215 | County of San Diego, Aging & Independance Services | Community/Behavioral Health | 4858 Del Mar Ave, San Diego, CA 92107 | 2007-05-03 |
| 1063535813 | James Wilson Jones | Dentist | 1499 Sunset Cliffs Blvd, San Diego, CA 92107 | 2007-04-09 |
| Find all providers in zip 92107 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881058345 | Telehealth Clinical Services | Non-Pharmacy Dispensing Site | 6088 Bounty St, San Diego, CA 92120-2942 | 2016-04-11 |
| 1194139212 | Arj Medical, Inc. | Non-Pharmacy Dispensing Site | 3645 El Cajon Blvd, San Diego, CA 92104-1514 | 2014-06-17 |
| 1386914422 | South Bay Internal Medicine and Family Practice | Non-Pharmacy Dispensing Site | 374 H Street, 202, San Diego, CA 92107 | 2012-01-06 |
| 1497780480 | Planned Parenthood of The Pacific Southwest | Non-Pharmacy Dispensing Site | 2017 1st Ave Ste 100, San Diego, CA 92101-9001 | 2006-07-11 |
| 1487041174 | Genesis Healthcare Partners Dispensary | Non-Pharmacy Dispensing Site | 3444 Kearny Villa Rd, Ste 201, San Diego, CA 92123-1959 | 2015-04-20 |
| 1912325622 | Arcana Sciences, Inc. | Non-Pharmacy Dispensing Site | 12250 El Camino Real, #108, San Diego, CA 92130-3076 | 2014-03-31 |
| 1750711610 | Oasis Md, Inc. | Non-Pharmacy Dispensing Site | 8901 Activity Rd, San Diego, CA 92126-4427 | 2013-11-13 |
| 1528405651 | Southern California Cardiology Medical Group, Inc. | Non-Pharmacy Dispensing Site | 6386 Alvarado Ct, Suite 101, San Diego, CA 92120-4905 | 2013-05-30 |
| 1598008583 | Stewart L. Frank Md, Inc. | Non-Pharmacy Dispensing Site | 4060 4th Ave, Suite 605, San Diego, CA 92103-2116 | 2013-03-28 |
| 1750650909 | Ron G. Soltero, M.d. Inc | Non-Pharmacy Dispensing Site | 4510 Executive Dr, Suite 105, San Diego, CA 92121-3021 | 2011-12-16 |
| 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.