Healthcare Provider Details
I. General information
NPI: 1427189042
Provider Name (Legal Business Name): NOBLE HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9834 GENESEE AVE SUITE 221
LA JOLLA CA
92037-1223
US
IV. Provider business mailing address
4670 TELESCOPE AVE
CARLSBAD CA
92008-3764
US
V. Phone/Fax
- Phone: 858-455-5307
- Fax: 858-455-5202
- Phone: 858-455-5307
- Fax: 858-455-5202
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | 20A6318 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
MELISSA
NOBLE
Title or Position: PRESIDENT
Credential: D.O.
Phone: 858-455-5307