South Bay Comprehensive Primary Care a Medical Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A55888 Issued in CA

Legal business name

SOUTH BAY COMPREHENSIVE PRIMARY CARE A MEDICAL CORP

Practice address

655 Saturn Blvd
Suite #J
San Diego, CA 92154-4734

Phone

(619) 575-4442

Fax

(619) 575-1297

NPI assigned

Jun 17, 2009

Last updated

Jun 17, 2009By 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

Sunnyline P Vendiola, M.D.

Title

President

Phone

(619) 575-4442

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1558598516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 SATURN BLVD",
            "address_2": "SUITE #J",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921544734",
            "telephone_number": "619-575-4442",
            "fax_number": "619-575-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 SATURN BLVD",
            "address_2": "SUITE #J",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921544734",
            "telephone_number": "619-575-4442",
            "fax_number": "619-575-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY COMPREHENSIVE PRIMARY CARE A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-17",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "VENDIOLA",
        "authorized_official_first_name": "SUNNYLINE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-575-4442",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A55888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Source Bioscience Inc
• Source Empowered Wellness
• Celesta Carla Sousa, BS
• John-Anthony Sousa
• South America Medical Network Inc
• South Bay Internal Medicine and Family Practice
• South Coast Gynecologic Oncology, Inc
• South Coast Home Health, Inc.
• South Coast Medical Supply LLC
• Aryn South

• Family Medicine Physician in San Diego, CA
• Providers in San Diego, 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 17, 2009; 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.