NPIMap

Organization Active NPI

Nathaniel G. Rose, M.D., a.P.C.

Doing business as dba Pacific Beach Urgent Care Med. Grp.

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1275689994
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G16726 Issued in CA
Legal business name
NATHANIEL G. ROSE, M.D., A.P.C.
Doing business as
dba Pacific Beach Urgent Care Med. Grp.
Practice address
4490 Fanuel St
San Diego, CA 92109-4292
Phone
(858) 274-9116
Fax
(858) 490-5321
NPI assigned
Jan 26, 2007
Last updated
Oct 11, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Lalo Avila
Title
Office Manager
Phone
(858) 274-9116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X G16726 CA Primary

Addresses

Primary practice location

4490 Fanuel St
San Diego, CA 92109-4292

Mailing address

4490 Fanuel St
San Diego, CA 92109-4292
Phone (858) 274-9116

Other names 1

  • dba Pacific Beach Urgent Care Med. Grp. Doing business as

National Provider Directory

National Provider Directory

Locations

4490 Fanuel St
San Diego, CA 92109
Phone (858) 274-9116

Practitioners & affiliated clinicians

Practitioners 3

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": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1275689994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4490 FANUEL ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094292",
            "telephone_number": "858-274-9116",
            "fax_number": "858-490-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4490 FANUEL ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094292",
            "telephone_number": "858-274-9116",
            "fax_number": "858-490-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATHANIEL G. ROSE, M.D., A.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "AVILA",
        "authorized_official_first_name": "LALO",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "858-274-9116"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G16726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Pacific Beach Urgent Care Med. Grp.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 11, 2007; 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.