Sgba Diversified Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

97888 Issued in CA

Legal business name

SGBA DIVERSIFIED INC

Doing business as

San Diego Medical Supply

Practice address

5735 Kearny Villa Rd Ste 101
San Diego, CA 92123-1138

Phone

(619) 644-2170

Fax

(619) 644-2174

NPI assigned

Feb 20, 2018

Organization subpart

No

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

Authorized official

Name

Stephen J Griswold

Title

President

Phone

(619) 644-2170

Specialties & licenses 1

Addresses

Other names 1

• San Diego Medical Supply Doing business as

Locations

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519084800000",
    "number": "1538669163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 KEARNY VILLA RD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231138",
            "telephone_number": "619-644-2170",
            "fax_number": "619-644-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5735 KEARNY VILLA RD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231138",
            "telephone_number": "619-644-2170",
            "fax_number": "619-644-2174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SGBA DIVERSIFIED INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-02-20",
        "status": "A",
        "authorized_official_last_name": "GRISWOLD",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-644-2170"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "97888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Diego Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gregory B Seymann, M.D.
• Mark Christopher Seymour
• Maren Badeya Sfeir
• Lucia Ioana Sfera, PT
• Emilie Sfregola, PSY.D.
• Allen Shaba
• Catherine Shaba
• Ghazi S. Shaba, MD
• Savana Shaba
• Ahmed S Shabaik, MD

• Durable Medical Equipment & Medical Supplies in San Diego, CA
• Providers in San Diego, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.