MEDICARE: PLANNED PARENTHOOD PACIFIC SOUTHWEST

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	261QC1500X	Community Health Clinic/Center		CA

General Provider Information

NPI Number	:	1306871397
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANNED PARENTHOOD PACIFIC SOUTHWEST

Provider Business Mailing Address
First Line	:	1075 CAMINO DEL RIO S
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3538
Country	:	US
Telephone Number	:	619-881-4500
Fax Number	:

Provider Business Practice Location Address
First Line	:	7035 CONVOY CT
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1016
Country	:	US
Telephone Number	:	619-881-4500
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	THERESA GONZALES
Credential	:
Telephone Number	:	619-881-4500

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/21/2022

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Directions to “PLANNED PARENTHOOD PACIFIC SOUTHWEST ” Practice Location

Language	Start Address	Practice Location

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