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General NPI Number Information
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NPI Number | 1134164460
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Entity Type | Organization
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Legal Business Name | QUALITYCARE MEDICAL CENTER INC.
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 840 TOWNSITE DRIVE
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City | VISTA
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State | CA
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Zip | 92084
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Country | US
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Telephone | 760-630-2422
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Fax | 760-630-3771
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Provider Business Mailing Address
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Address Line | 840 TOWNSITE DRIVE
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City | VISTA
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State | CA
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Zip | 92084
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Country | US
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Telephone | 760-630-2422
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Fax | 760-630-3771
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Authorized Official
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Title or Position | CHIEF PROCESSING OFFICER, INSURANCE
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Name | RUSSELL L MUTSCHLER
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Credential |
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Telephone | 760-630-2422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A37015
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License Number State | CA
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