MEDICARE: GEORGE DELGADO M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician	G66807	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083639470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE DELGADO M.D

Provider Business Mailing Address
First Line	:	5030 CAMINO DE LA SIESTA STE 106
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3117
Country	:	US
Telephone Number	:	619-692-4401
Fax Number	:	619-692-8147

Provider Business Practice Location Address
First Line	:	5030 CAMINO DE LA SIESTA STE 106
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3117
Country	:	US
Telephone Number	:	619-692-4401
Fax Number	:	619-692-8147

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	03/17/2018

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