CCTC, Corp

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

CCTC, CORP

Practice address

6244 El Cajon Blvd
San Diego, CA 92115-3918

Phone

(888) 628-6680

NPI assigned

Jan 23, 2019

Last updated

Jan 23, 2019By 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

Enrique Chung

Title

President

Phone

(619) 253-6451

Specialties & licenses 1

Addresses

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.

• Efrain Lopez, FNP

  • Family Nurse Practitioner
  • San Diego, CA
  • NPI 1609340835
  NPD (past)
• Marco Martinez, FNP

  • Primary Care Nurse Practitioner
  • Chula Vista, CA
  • NPI 1922542182
  NPD (past)

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1538623681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 HOPLAND CT",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6244 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921153918",
            "telephone_number": "888-628-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCTC, CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-253-6451"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorge Cazarez, CPT 9580
• Alejandro Cazessus
• Juan Luis Cazessus
• Marlie Cazier
• Francesca Elena Traber Cazzulino, MD
• CCW la Jolla, LLC (Vi at La Jolla Village)
• CCW la Jolla, LLC
• CDM Health Care Inc. (Always Best Care Senior Services)
• CDM Living Life, Inc. (Always Best Care Senior Services)
• German Cea

• Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.