Healthcare Provider Details
I. General information
NPI: 1811042906
Provider Name (Legal Business Name): PREMIERE PULMONARY CONSULTANTS A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/25/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
502 EUCLID AVE SUITE 304
NATIONAL CITY CA
91950-2931
US
IV. Provider business mailing address
502 EUCLID AVE SUITE 304
NATIONAL CITY CA
91950-2931
US
V. Phone/Fax
- Phone: 619-470-6195
- Fax: 619-470-6199
- Phone: 619-470-6195
- Fax: 619-470-6199
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | A48932 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | A48932 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
DOTTIE
ANN
SAZON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 619-470-6195