Healthcare Provider Details

I. General information

NPI: 1740347210
Provider Name (Legal Business Name): CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF ENDO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8110 BIRMINGHAM WAY BUILDING 28
SAN DIEGO CA
92123-2758
US

IV. Provider business mailing address

3860 CALLE FORTUNADA SUITE 210
SAN DIEGO CA
92123-4800
US

V. Phone/Fax

Practice location:
  • Phone: 858-966-4032
  • Fax:
Mailing address:
  • Phone: 858-309-6303
  • Fax: 858-309-6301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SEGALL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 858-576-1700