NPIMap

Organization Active NPI

Primary Care Physicians of South Bay Medical Group Inc

  • Family Medicine Physician
  • National City, CA
National Provider Identifier
1003124363
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A42911 Issued in CA
Legal business name
PRIMARY CARE PHYSICIANS OF SOUTH BAY MEDICAL GROUP INC
Practice address
2340 E 8TH St
Suite a
National City, CA 91950-2869
Phone
(619) 267-9047
Fax
(619) 267-7955
NPI assigned
Sep 21, 2010
Last updated
Jun 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carlos A Castro, MDNPI 1518071604
Title
President
Phone
(619) 267-9047

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A42911 CA Primary

Addresses

Primary practice location

2340 E 8TH St
Suite a
National City, CA 91950-2869

Mailing address

2340 E 8TH St
Suite a
National City, CA 91950-2869
Phone (619) 267-9047

Other identifiers 1

IdentifierTypeStateIssuer
A42911OtherCATHE MEDICAL BOARD OF CALIFORNIA

National Provider Directory

National Provider Directory

Locations

2340 E 8th St
Ste A
National City, CA 91950
Phone (619) 267-9047

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309305600000",
    "number": "1003124363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 E 8TH ST",
            "address_2": "SUITE A",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502869",
            "telephone_number": "619-267-9047",
            "fax_number": "619-267-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 E 8TH ST",
            "address_2": "SUITE A",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502869",
            "telephone_number": "619-267-9047",
            "fax_number": "619-267-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE PHYSICIANS OF SOUTH BAY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-21",
        "last_updated": "2011-06-29",
        "status": "A",
        "authorized_official_last_name": "CASTRO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-267-9047",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A42911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE MEDICAL BOARD OF CALIFORNIA",
            "identifier": "A42911",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.