Active NPI
Vetren LLC
- Multi-Specialty Clinic/Center
- San Diego, CA
National Provider Identifier
1902620545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- Legal business name
- VETREN LLC
- Practice address
- 9051 Mira Mesa Blvd Unit 261403
San Diego, CA 92196-7058 - Phone
- (805) 626-7796
- NPI assigned
- Nov 11, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jasper Orr
- Title
- Owner
- Phone
- (805) 626-7796
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Adult Day Care Clinic/Center | 261QA0600X | |||
| Community Health Clinic/Center | 261QC1500X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | Primary | ||
| Comprehensive Outpatient Rehabilitation Facility (CORF) | 261QR0401X | |||
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | |||
| Substance Abuse Rehabilitation Facility | 324500000X |
Addresses
Primary practice location
9051 Mira Mesa Blvd Unit 261403
San Diego, CA 92196-7058
Mailing address
9051 Mira Mesa Blvd Unit 261403
San Diego, CA 92196-7058
National Provider Directory
National Provider DirectoryLocations
9051 Mira Mesa Blvd
Unit 261403
San Diego, CA 92196
Phone (805) 626-7796
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731283200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1731283200000",
"number": "1902620545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9051 MIRA MESA BLVD UNIT 261403",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921967058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9051 MIRA MESA BLVD UNIT 261403",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921967058",
"telephone_number": "805-626-7796"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VETREN LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-11-11",
"last_updated": "2024-11-11",
"certification_date": "2024-11-11",
"status": "A",
"authorized_official_last_name": "ORR",
"authorized_official_first_name": "JASPER",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "805-626-7796"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QC1500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Community Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QR0401X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": null,
"license": null,
"primary": false
},
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"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 Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.