Healthcare Provider Details

I. General information

NPI: 1467906321
Provider Name (Legal Business Name): KEVIN T. MURPHY, MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2016
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12625 HIGH BLUFF DR STE 318
SAN DIEGO CA
92130-2054
US

IV. Provider business mailing address

12625 HIGH BLUFF DR STE 318
SAN DIEGO CA
92130-2054
US

V. Phone/Fax

Practice location:
  • Phone: 858-924-1116
  • Fax: 858-312-5397
Mailing address:
  • Phone: 858-924-1116
  • Fax: 858-312-5397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. KEVIN MURPHY
Title or Position: MD/OWNER
Credential: MD
Phone: 858-924-1116