NPIMap

Organization Active NPI

Genesee Medical Group Inc

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1043480320
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G45791 Issued in CA
Legal business name
GENESEE MEDICAL GROUP INC
Practice address
7830 Clairemont Mesa Blvd
Suite 100
San Diego, CA 92111-1619
Phone
(858) 268-1111
Fax
(858) 268-0761
NPI assigned
Mar 3, 2008
Last updated
Apr 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Authorized official

Name
Dr. Donald P Tecca, MDNPI 1235163163
Title
Owner
Phone
(858) 268-1111

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X G45791 CA Primary

Addresses

Primary practice location

7830 Clairemont Mesa Blvd
Suite 100
San Diego, CA 92111-1619

Mailing address

7830 Clairemont Mesa Blvd
Suite 100
San Diego, CA 92111-1619
Phone (858) 268-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050218000386 CA Part B Supplier - Clinic/Group Practice 1254325350 Receives reassigned benefits from 8 practitioners
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

3880 Murphy Canyon Rd
San Diego, CA 92123
Phone (888) 552-9775

3880 Murphy Canyon Rd
Ste 1
San Diego, CA 92123

Practitioners & affiliated clinicians

Practitioners 12

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": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588118400000",
    "number": "1043480320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7830 CLAIREMONT MESA BLVD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111619",
            "telephone_number": "858-268-1111",
            "fax_number": "858-268-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7830 CLAIREMONT MESA BLVD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111619",
            "telephone_number": "858-268-1111",
            "fax_number": "858-268-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESEE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A",
        "authorized_official_last_name": "TECCA",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-268-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G45791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.