Healthcare Provider Details

I. General information

NPI: 1942120787
Provider Name (Legal Business Name): MAREA MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 RIVERVIEW PKWY STE 101
SANTEE CA
92071-5832
US

IV. Provider business mailing address

415 LAUREL ST # 3149
SAN DIEGO CA
92101-1605
US

V. Phone/Fax

Practice location:
  • Phone: 619-363-2330
  • Fax: 619-353-2550
Mailing address:
  • Phone: 619-363-2330
  • Fax: 619-353-2550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOYCE ILDESA
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 619-665-8363