Healthcare Medical Group of la Mesa

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

A42653 Issued in CA

Legal business name

HEALTHCARE MEDICAL GROUP OF LA MESA

Practice address

7339 El Cajon Blvd
La Mesa, CA 91941-3435

Phone

(619) 698-0606

NPI assigned

Nov 26, 2008

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

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

Authorized official

Name

Scott Peterson

Title

Cfo

Phone

(858) 625-2990

Specialties & licenses 1

Addresses

Part of

Tri - State Medical Group Inc

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484265600000",
    "number": "1962657395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9276 SCRANTON RD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921217701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7339 EL CAJON BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919413435",
            "telephone_number": "619-698-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCARE MEDICAL GROUP OF LA MESA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2008-11-26",
        "last_updated": "2017-01-13",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "A42653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Hayden, PSY.D.
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• Non-Pharmacy Dispensing Site in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Non-Pharmacy Dispensing Site in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.