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NPI Code Detail

MEDICARE: SYCUAN TRIBAL GOVERNMENT

MEDICARE: SYCUAN TRIBAL GOVERNMENT
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
1261Q00000XClinic/CenterG49297CA

General Provider Information

NPI Number : 1629056999
Entity Type Code : Organization
Provider Name (Legal Business Name) : SYCUAN TRIBAL GOVERNMENT
Provider Business Mailing Address
First Line : 5442 SYCUAN RD
Second Line :
City : EL CAJON
State : CA
Zip : 92019-1816
Country : US
Telephone Number : 619-445-0707
Fax Number :
Provider Business Practice Location Address
First Line : 5442 SYCUAN RD
Second Line :
City : EL CAJON
State : CA
Zip : 92019-1816
Country : US
Telephone Number : 619-445-0707
Fax Number :
Authorized Official
Title or Position : CLINI DIRECTOR
Name : DR. DANIEL L BARBARA SR.
Credential :
Telephone Number : 619-445-0707
Provider Enumeration Date : 01/05/2006
Last Update Date : 10/10/2018

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Directions to “SYCUAN TRIBAL GOVERNMENT ” Practice Location

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