Southbay Community Health Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A35268 Issued in CA

Legal business name

SOUTHBAY COMMUNITY HEALTH CENTER

Practice address

1463 E Plaza Blvd
National City, CA 91950-3613

Phone

(619) 474-6900

Fax

(619) 474-0624

NPI assigned

Mar 7, 2014

Organization subpart

No

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

Authorized official

Name

Boniffacio C Esperanza, M.D.

Title

Director

Phone

(858) 500-2846

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394150400000",
    "number": "1073939591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 E PLAZA BLVD",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919503613",
            "telephone_number": "619-474-6900",
            "fax_number": "616-474-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 E PLAZA BLVD",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919503613",
            "telephone_number": "619-474-6900",
            "fax_number": "619-474-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHBAY COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-07",
        "last_updated": "2014-03-07",
        "status": "A",
        "authorized_official_last_name": "ESPERANZA",
        "authorized_official_first_name": "BONIFFACIO",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "858-500-2846",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A35268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOA352680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Learsi Randon Solano
• Miladys Sosa, MSPT
• South Bay Foot & Ankle Specialists, Inc.
• South Bay OB/GYN Medical Group, Inc.
• South Bay Psychiatry, a Professional Corporation
• Southern California Sleep Clinic a Professional Medical Corporation
• Yvette St Martin, N.P.
• Colleen Marie Stallmer, CRNA
• Shilo Hope Meleana Stanley, CMT
• Christopher Stelzer

• Family Medicine Physician in National City, CA
• Providers in National City, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; 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.