Healthcare Provider Details

I. General information

NPI: 1104860865
Provider Name (Legal Business Name): FRANCISCO S. PARDO MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 1ST AVE SUITE 200 B
SAN DIEGO CA
92101-2685
US

IV. Provider business mailing address

2140 HAYDEN WAY
SAN DIEGO CA
92110-2126
US

V. Phone/Fax

Practice location:
  • Phone: 619-793-7988
  • Fax: 619-269-4302
Mailing address:
  • Phone: 619-519-0989
  • Fax: 619-269-3402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberG57474
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG57474
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG57474
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberG57474
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberG57474
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG57474
License Number StateCA

VIII. Authorized Official

Name: DR. FRANCISCO S. PARDO
Title or Position: CEO
Credential: MD
Phone: 619-519-0989