Healthcare Provider Details

I. General information

NPI: 1194429233
Provider Name (Legal Business Name): SAN DIEGO EMERGENCY PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 FROST ST
SAN DIEGO CA
92123-2701
US

IV. Provider business mailing address

7901 FROST ST
SAN DIEGO CA
92123-2701
US

V. Phone/Fax

Practice location:
  • Phone: 858-939-3400
  • Fax:
Mailing address:
  • Phone: 858-939-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH BELLEZZO
Title or Position: PRESIDENT
Credential: MD
Phone: 858-939-3400