Healthcare Provider Details

I. General information

NPI: 1679491674
Provider Name (Legal Business Name): TEIGAN MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3590 CAMINO DEL RIO N STE 200
SAN DIEGO CA
92108-1707
US

IV. Provider business mailing address

3590 CAMINO DEL RIO N STE 200
SAN DIEGO CA
92108-1707
US

V. Phone/Fax

Practice location:
  • Phone: 619-810-1275
  • Fax: 619-810-1011
Mailing address:
  • Phone: 619-810-1275
  • Fax: 619-810-1011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SANJAY GHOSH
Title or Position: PRESIDENT
Credential: MD
Phone: 619-810-1010