Southbay Neurological Med GR

Primary specialty

SpecialistTaxonomy code 174400000X

License

2084N0400X Issued in CA

Legal business name

SOUTHBAY NEUROLOGICAL MED GR

Practice address

360 H St
Chula Vista, CA 91910-5511

Phone

(619) 585-7227

Fax

(619) 585-3190

NPI assigned

Mar 8, 2006

Organization subpart

No

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

Authorized official

Name

Blanca Gamboa, CPC

Title

Office Manager

Phone

(619) 585-7227

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395100800000",
    "number": "1093783045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 H ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105511",
            "telephone_number": "619-585-7227",
            "fax_number": "619-585-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 H ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105511",
            "telephone_number": "619-585-7227",
            "fax_number": "619-585-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHBAY NEUROLOGICAL MED GR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2014-03-18",
        "status": "A",
        "authorized_official_last_name": "GAMBOA",
        "authorized_official_first_name": "BLANCA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "619-585-7227",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "2084N0400X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Bay Physical Medicine, Inc.
• South Bay Serenity and Guidance
• South Bay Skin & Cancer Medical Group, Inc.
• South Bay Surgical Associates Medical Group Inc.
• Southbay Cardiovascular Medical Center, Inc
• Southern California Anesthesia Services, LLC
• Southern California Fatty Liver Center Inc
• Southern California Health Providers Medical GRP Inc
• Southern Regional Resource Center
• Southwest Pulmonary Medical Group a Medical Corporation

• Specialist in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.