Socal Medical Clinics

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

SOCAL MEDICAL CLINICS

Practice address

2878 Camino del Rio S Ste 220
San Diego, CA 92108-3845

Phone

(619) 241-2191

NPI assigned

Apr 17, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Gerson, MDNPI 1881843431

Title

Ceo

Phone

(619) 241-2191

Specialties & licenses 1

Addresses

Other names 1

• REVIVE WOUND GROUP Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel Jeffrey Gerson, M.D.

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1881843431

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1744848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1467248252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2878 CAMINO DEL RIO S STE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083845",
            "telephone_number": "619-241-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2878 CAMINO DEL RIO S STE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083845",
            "telephone_number": "619-241-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL MEDICAL CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "GERSON",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-241-2191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REVIVE WOUND GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "REVIVE WOUND GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Socal Breastfeeding LLC
• Socal Chiropractic
• Socal Foot Care PC
• Socal Hand Therapy, Inc
• Socal Kids Occupational Therapy, P.C.
• Socal Nursing Wound Care PC
• Socal Occupational Therapy
• Socal OT Solutions PC
• Socal Psych Solutions
• Socal Speech Therapy & OT

• General Practice Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.