Healthcare Provider Details

I. General information

NPI: 1700258597
Provider Name (Legal Business Name): VERDOLIN MEDICOLEGAL CONSULTING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 HALE PL STE 102
CHULA VISTA CA
91914-3598
US

IV. Provider business mailing address

910 HALE PL STE 102
CHULA VISTA CA
91914-3598
US

V. Phone/Fax

Practice location:
  • Phone: 619-625-1144
  • Fax:
Mailing address:
  • Phone: 619-625-1144
  • Fax: 619-271-4060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL HENRY VERDOLIN
Title or Position: PRESIDENT/ CEO
Credential: MD
Phone: 619-625-1144