NPI 1023425972
Southern California Permanente Medical Group
Practice location
- Address
- 1288 Camino del Rio N, San Diego, CA 92108-1511
- Phone
- (877) 608-0044
- Mailing address
- 393 E Walnut St Provider Enrollment, 3rd Floor, Pasadena, CA 91188-0001
Authorised official
- Name
- Ramin Davidoff
- Title
- Executive Medical Director
- Phone
- (877) 608-0044
Registered specialties
Health Maintenance Organization
Primary
Registry record
- NPI
- 1023425972
- Entity type
- Organization
- NPI issued
- 11 Jul 2014
- Record last updated
- 2 Nov 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.