The Bridges of San Diego, Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

THE BRIDGES OF SAN DIEGO, INC.

Practice address

5480 Baltimore Dr Ste 211
La Mesa, CA 91942-2066

Phone

(619) 750-6626

Fax

(501) 679-5575

NPI assigned

Oct 24, 2017

Organization subpart

No

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

Authorized official

Name

David Liesch

Title

President

Phone

(619) 750-6626

Specialties & licenses 1

Addresses

Other names 1

• The Bridges of San Diego Doing business as

Locations

Practitioners 1

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

• Fred Keith Berger, M.D.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • San Diego, CA
  • NPI 1508890021
  NPD (past)

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586217600000",
    "number": "1548772007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 AVOCADO BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919417301",
            "telephone_number": "619-750-6626",
            "fax_number": "501-679-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 BALTIMORE DR STE 211",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422066",
            "telephone_number": "619-750-6626",
            "fax_number": "501-679-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BRIDGES OF SAN DIEGO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-24",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A",
        "authorized_official_last_name": "LIESCH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-750-6626"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Bridges of San Diego",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aida Tesfaye-Kedjela, MD
• Sinafikish T Tessema, NP
• Phuong T Thai, PHARMD
• Cynthia Ann Thayer, LCSW
• Leslie Jean Bennett Thayer, PH.D
• The Cataract Vision Institute LLC
• The Heart Center of San Diego Medical Group, Inc
• The Kensington Agency Inc
• The Lasik Vision Institute LLC
• The Rover Group, Inc.

• Substance Abuse Rehabilitation Facility in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; 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.