SK Medical Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

FNP41999 Issued in CA

Legal business name

SK MEDICAL CLINIC

Practice address

911 E Valley Pkwy
Escondido, CA 92025-3428

Phone

(760) 520-1920

Fax

(760) 741-2026

NPI assigned

Oct 24, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Martin Kabongo, MD

Title

Ceo

Phone

(760) 520-1920

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1295088466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 E VALLEY PKWY",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253428",
            "telephone_number": "760-520-1920",
            "fax_number": "760-741-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 E VALLEY PKWY",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253428",
            "telephone_number": "760-520-1920",
            "fax_number": "760-741-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SK MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-24",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "KABONGO",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-520-1920",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "FNP41999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerome Lawrence Sinsky, M.D.
• Jessie Genise Siono
• Kelly Sisler, LMFT
• Garrick T Sit, O.D.
• Dawn Sizemore, PSS
• Sandra Skal-Gerlock
• Zoe Skerlos
• David Slack, MD
• Robyn Marie Slayton-Lopez
• Julia A. Sledge

• Primary Care Clinic/Center in Escondido, CA
• Providers in Escondido, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; 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.