Healthcare Provider Details

I. General information

NPI: 1093417206
Provider Name (Legal Business Name): MDS BY THE SEA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N COAST HIGHWAY 101
ENCINITAS CA
92024-1441
US

IV. Provider business mailing address

PO BOX 300
SOLANA BEACH CA
92075-0300
US

V. Phone/Fax

Practice location:
  • Phone: 619-483-6694
  • Fax: 858-227-0853
Mailing address:
  • Phone: 619-483-6694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK FRANCIS BURGER
Title or Position: CHIEF FINANCIAL OFFICER
Credential: MD
Phone: 619-483-6694