Aeron D Wickes MD Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G55311 Issued in CA

Legal business name

AERON D WICKES MD INC

Doing business as

Sabre Springs Medical Clinic

Practice address

12650 Sabre Springs Pkwy Ste 204
San Diego, CA 92128-4114

Phone

(858) 679-9262

Fax

(858) 679-1885

NPI assigned

Jan 25, 2007

Last updated

Aug 22, 2020By 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

Dr. Aeron Wickes, M.D.NPI 1306804380

Title

President

Phone

(858) 679-9262

Specialties & licenses 1

Addresses

Other names 1

• Sabre Springs Medical Clinic Doing business as

Practitioners 1

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.

• Aeron D. Wickes, M.D.

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1306804380
  Authorized official Same address or phone

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821144726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12650 SABRE SPRINGS PKWY STE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284114",
            "telephone_number": "858-679-9262",
            "fax_number": "858-679-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12650 SABRE SPRINGS PKWY STE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284114",
            "telephone_number": "858-679-9262",
            "fax_number": "858-679-1885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AERON D WICKES MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WICKES",
        "authorized_official_first_name": "AERON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-679-9262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G55311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sabre Springs Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Abhinay Reddy Aeruva
• Aetna Better Health of California Inc.
• Niloofar Afari, PHD
• Meskerem D Afework, LVN
• Michon Affinito, PPS

• 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 Aug 22, 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.