NPIMap

Organization Active NPI

Mobile Medical Group

  • Geriatric Medicine (Family Medicine) Physician
  • San Diego, CA
National Provider Identifier
1962413583
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
MOBILE MEDICAL GROUP
Practice address
5030 Camino de la Siesta
Ste 208
San Diego, CA 92108-3117
Phone
(619) 260-6300
Fax
(619) 260-6313
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2009

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

Authorized official

Name
Dr. Cary Gresham Bayne, MDNPI 1366463218
Title
Owner
Phone
(619) 260-6300

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
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X Primary

Addresses

Primary practice location

5030 Camino de la Siesta
Ste 208
San Diego, CA 92108-3117

Mailing address

5030 Camino de la Siesta
Ste 208
San Diego, CA 92108-3117
Phone (619) 260-6300

Other identifiers 2

IdentifierTypeStateIssuer
GR0089290MedicaidCA
ZZZ61626ZOtherCABLUE SHIELD

Other names 1

  • Call Doctor Medical Group Doing business as

National Provider Directory

National Provider Directory

Locations

5030 Camino de la Siesta
Ste 208
San Diego, CA 92108
Phone (619) 260-6300

Practitioners & affiliated clinicians

Practitioners 7

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": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234224000000",
    "number": "1962413583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 CAMINO DE LA SIESTA",
            "address_2": "STE 208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083117",
            "telephone_number": "619-260-6300",
            "fax_number": "619-260-6313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 CAMINO DE LA SIESTA",
            "address_2": "STE 208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083117",
            "telephone_number": "619-260-6300",
            "fax_number": "619-260-6313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2009-02-10",
        "status": "A",
        "authorized_official_last_name": "BAYNE",
        "authorized_official_first_name": "CARY",
        "authorized_official_middle_name": "GRESHAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-260-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0089290",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ61626Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Call Doctor Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 10, 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.