Healthcare Provider Details
I. General information
NPI: 1487591285
Provider Name (Legal Business Name): TRI-CITY MEDICAL CENTER CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4002 VISTA WAY
OCEANSIDE CA
92056-4506
US
IV. Provider business mailing address
8695 SPECTRUM CENTER BLVD
SAN DIEGO CA
92123-1489
US
V. Phone/Fax
- Phone: 760-724-8411
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 273R00000X |
| Taxonomy | Psychiatric Hospital Unit |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
SCOTT
EVANS
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 619-740-4648