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General NPI Number Information
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NPI Number | 1619502572
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Entity Type | Organization
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Legal Business Name | PACIFIC ENDOCRINOLOGY
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Dates
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Enumeration Date | 03/11/2020
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Last Update Date | 03/17/2020
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Provider Practice Location Address
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Address Line | 1855 1ST AVE STE 200B
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City | SAN DIEGO
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State | CA
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Zip | 92101-2685
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Country | US
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Telephone | 619-432-1033
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Fax | 619-310-5426
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Provider Business Mailing Address
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Address Line | 1855 1ST AVE STE 200B
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City | SAN DIEGO
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State | CA
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Zip | 92101-2685
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LISA STRAHM
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Credential | MD
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Telephone | 619-432-1033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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