San Diego Physicians Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A76454 Issued in CA

Legal business name

SAN DIEGO PHYSICIANS CLINIC

Practice address

10737 Camino Ruiz
Suite 200
San Diego, CA 92126

Phone

(858) 653-0147

Fax

(858) 653-0432

NPI assigned

Sep 8, 2006

Last updated

Jul 25, 2024By 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

Tung N Lai, MDNPI 1154317022

Title

President

Phone

(858) 653-0147

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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.

• Tung N Lai, MD

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1154317022
  Medicare reassignment NPD Authorized official
• Kathleen Hamilton O'Sullivan, APRN, FNP-BC

  • Family Nurse Practitioner
  • San Diego, CA
  • NPI 1982409785
  NPD (past)

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1427152701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10737 CAMINO RUIZ",
            "address_2": "SUITE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92126",
            "telephone_number": "858-653-0147",
            "fax_number": "858-653-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10737 CAMINO RUIZ",
            "address_2": "SUITE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92126",
            "telephone_number": "858-653-0147",
            "fax_number": "858-653-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO PHYSICIANS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "LAI",
        "authorized_official_first_name": "TUNG",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-653-0147",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A76454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• San Diego Orthopaedic Associates Medical Group, Inc.
• San Diego Pathologists Medical Group Inc
• San Diego Pathologists Medical Group Inc
• San Diego Pediatric Neurology, Inc.
• San Diego Pharmacy
• San Diego Physicians Medical Group
• San Diego Premier Surgery Center LLC
• San Diego Prep Inc
• San Diego Primary Care Medical Group (Clairemont Family Medical Clinic)
• San Diego Psychiatric Medical Group Inc

• Internal Medicine Physician in San Diego, CA
• Providers in San Diego, 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 Jul 25, 2024; 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.