Chula Vista Internal Medicine & Cardiology Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CHULA VISTA INTERNAL MEDICINE & CARDIOLOGY MEDICAL GROUP

Practice address

754 Medical Center CT
Ste 100
Chula Vista, CA 91911

Phone

(619) 421-4000

Fax

(619) 421-6395

NPI assigned

Mar 27, 2007

Last updated

Sep 26, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Elizabeth J Polkinghorne

Title

Office Manager

Phone

(619) 421-4000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 5

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.

• David Preston Hansen, MD

  • Internal Medicine Physician
  • Chula Vista, CA
  • NPI 1275647521
  Medicare reassignment Care Compare group NPD
• Marco Martinez, FNP

  • Primary Care Nurse Practitioner
  • Chula Vista, CA
  • NPI 1922542182
  Medicare reassignment Care Compare group NPD
• Gregory T Czer, MD

  • Internal Medicine Physician
  • Chula Vista, CA
  • NPI 1932218963
  Medicare reassignment NPD
• Luis Daniel San Miguel, DNP, FNP

  • Family Nurse Practitioner
  • Chula Vista, CA
  • NPI 1982088613
  Medicare reassignment
• Luis A. Fiallo, M.D., F.A.C.P.

  • Critical Care Medicine (Internal Medicine) Physician
  • El Centro, CA
  • NPI 1407824600
  NPD (past)

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1144348962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 MEDICAL CENTER CT",
            "address_2": "STE 100",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91911",
            "telephone_number": "619-421-4000",
            "fax_number": "619-421-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 MEDICAL CENTER CT",
            "address_2": "STE 100",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91911",
            "telephone_number": "619-421-4000",
            "fax_number": "619-421-6395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHULA VISTA INTERNAL MEDICINE & CARDIOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "POLKINGHORNE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "619-421-4000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chula Vista Dental Care
• Chula Vista Elementary School District
• Chula Vista Emergency Room Physicians, a Medical Corporation
• Chula Vista Heart Clinic, Inc.
• Chula Vista Imaging
• Chula Vista OB Hospitalist Group Inc
• Chula Vista Periodontics
• Chula Vista Womens Care Inc (lifetime womens healthcare)
• Chulavista Pharmacy LLC (Chulavista Pharmacy)
• Chulavista Pharmacy LLC (Chulavista Pharmacy LLC LTC)

• Internal Medicine Physician in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.