NPIMap

Organization Active NPI

Neurosurgical Medical Clinic, Inc,

  • Neurological Surgery Physician
  • San Diego, CA
National Provider Identifier
1881709673
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
NEUROSURGICAL MEDICAL CLINIC, INC,
Practice address
3750 Convoy St Ste 301
San Diego, CA 92111-3741
Phone
(619) 297-4481
Fax
(619) 291-5536
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Sohaib A. Kureshi, M.D.NPI 1699888917
Title
President
Phone
(619) 297-4481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X CA Primary

Addresses

Primary practice location

3750 Convoy St Ste 301
San Diego, CA 92111-3741

Mailing address

3750 Convoy St Ste 301
San Diego, CA 92111-3741
Phone (619) 297-4481

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ47852ZMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050519001152 CA Part B Supplier - Clinic/Group Practice 3375584287 Receives reassigned benefits from 11 practitioners
Practice locations: San Diego, CA; La Mesa, CA

National Provider Directory

National Provider Directory

Locations

300 S Pierce St
Ste 101
El Cajon, CA 92020

635 E Grand Ave
Escondido, CA 92025
Phone (760) 739-7666

7920 Frost St
Ste 400
San Diego, CA 92123

501 Washington St
Ste 700
San Diego, CA 92103

3750 Convoy St
Ste 3001
San Diego, CA 92111

3750 Convoy St
Ste 3010
San Diego, CA 92111

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1881709673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 CONVOY ST STE 301",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113741",
            "telephone_number": "619-297-4481",
            "fax_number": "619-291-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 CONVOY ST STE 301",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113741",
            "telephone_number": "619-297-4481",
            "fax_number": "619-291-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROSURGICAL MEDICAL CLINIC, INC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2022-07-21",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "KURESHI",
        "authorized_official_first_name": "SOHAIB",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-297-4481",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ47852Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.