Healthcare Provider Details

I. General information

NPI: 1952440133
Provider Name (Legal Business Name): RANCHO SANTA FE MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 WARING CT STE Q
OCEANSIDE CA
92056-4509
US

IV. Provider business mailing address

3230 WARING CT STE Q
OCEANSIDE CA
92056-4509
US

V. Phone/Fax

Practice location:
  • Phone: 760-591-9975
  • Fax:
Mailing address:
  • Phone: 760-591-9975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LUIS JOSEPH NAVAZO
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 760-591-9975