Grossmont Medical Clinic a Professional Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GROSSMONT MEDICAL CLINIC A PROFESSIONAL CORPORATION

Practice address

8851 Center Dr
Suite 408
La Mesa, CA 91942-3017

Phone

(619) 589-8626

Fax

(619) 589-8864

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John R Webb, M.D.

Title

President

Phone

(619) 589-8626

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1508967662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 261699",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921961699",
            "telephone_number": "619-589-8626",
            "fax_number": "619-589-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8851 CENTER DR",
            "address_2": "SUITE 408",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423017",
            "telephone_number": "619-589-8626",
            "fax_number": "619-589-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROSSMONT MEDICAL CLINIC A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-589-8626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0053450",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ34565Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grossmont Hospital Corporation
• Grossmont Hospital Corporation
• Grossmont Imaging, LLC
• Grossmont Ipg LTD
• Grossmont Medical Center Acupuncture Clinic
• Grossmont OB/GYN Medical Group Inc
• Grossmont Outpatient Surgical Center
• Grossmont Pediatrics Operated by Neighborhood Healthcare
• Grossmont Skilled Care, Inc.
• Grossmont Surgery Center LP

• Family Medicine Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.