Healthcare Provider Details

I. General information

NPI: 1427268747
Provider Name (Legal Business Name): PHILIP D SZOLD MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8881 FLETCHER PARKWAY SUITE 205
LA MESA CA
91942-3135
US

IV. Provider business mailing address

8881 FLETCHER PARKWAY SUITE 205
LA MESA CA
91942-3135
US

V. Phone/Fax

Practice location:
  • Phone: 619-464-6434
  • Fax: 619-464-5109
Mailing address:
  • Phone: 619-464-6434
  • Fax: 619-464-5109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: KYRRA MOFFATT
Title or Position: CEO
Credential: DO
Phone: 619-464-6434