NPIMap

Organization Active NPI

San Diego Health Alliance

  • Methadone Clinic
  • San Marcos, CA
National Provider Identifier
1780787747
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
3714 Issued in CA
Legal business name
SAN DIEGO HEALTH ALLIANCE
Doing business as
Capalina Clinic
Practice address
1560 Capalina Clinic
San Marcos, CA 92069
Phone
(760) 744-2104
Fax
(760) 744-1382
NPI assigned
Sep 6, 2006
Organization subpart
Yes
Parent organization
SAN DIEGO HEALTH ALLIANCEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Authorized official

Name
Brian Phillip Farley
Title
VP & Secretary
Phone
(615) 861-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X 3714 CA Primary

Addresses

Primary practice location

1560 Capalina Clinic
San Marcos, CA 92069

Mailing address

6183 Paseo del Norte
Ste 200
Carlsbad, CA 92011-1151
Phone (855) 259-2288

Other identifiers 1

IdentifierTypeStateIssuer
8778MedicaidCA

Other names 1

  • Capalina Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200121000541 CA Part B Supplier - Opioid Treatment Program (Otp) 4183059116 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: El Cajon, CA; San Diego, CA; San Marcos, CA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
San Diego Health Alliance7 organizations share this tax ID, including this one
Part of
San Diego Health Alliance

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

234 N Magnolia Ave
El Cajon, CA 92020
Phone (619) 333-4240

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691712000000",
    "number": "1780787747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6183 PASEO DEL NORTE",
            "address_2": "STE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111151",
            "telephone_number": "855-259-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 CAPALINA CLINIC",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "92069",
            "telephone_number": "760-744-2104",
            "fax_number": "760-744-1382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO HEALTH ALLIANCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN DIEGO HEALTH ALLIANCE",
        "enumeration_date": "2006-09-06",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "VP & SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "CA",
            "license": "3714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8778",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capalina Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Capalina Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.