Healthcare Provider Details

I. General information

NPI: 1518850825
Provider Name (Legal Business Name): RECOVER MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 E VALLEY PKWY STE D
ESCONDIDO CA
92025-3441
US

IV. Provider business mailing address

120 BIRMINGHAM DR STE 240A
CARDIFF CA
92007-1757
US

V. Phone/Fax

Practice location:
  • Phone: 858-208-0121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS GULINO
Title or Position: ADMINISTRATOR
Credential:
Phone: 858-208-0121