Healthcare Provider Details

I. General information

NPI: 1629933635
Provider Name (Legal Business Name): SEEN MEDICAL GROUP OF SAN DIEGO, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 VILLA LA JOLLA DR STE C227
LA JOLLA CA
92037-1712
US

IV. Provider business mailing address

15 OAK ST STE 3
NEEDHAM MA
02492-2470
US

V. Phone/Fax

Practice location:
  • Phone: 888-671-5902
  • Fax: 339-686-3137
Mailing address:
  • Phone: 339-793-8998
  • Fax: 339-686-3137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: BRITTA REIERSON
Title or Position: PC OWNER
Credential: MD
Phone: 315-216-2910