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General NPI Number Information
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NPI Number | 1932108115
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Entity Type | Organization
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Legal Business Name | NORTH COUNTY INPATIENT MEDICAL ALLIANCE, A MEDICAL GROUP, INC
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 11/20/2009
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Provider Practice Location Address
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Address Line | 354 SANTA FE DR
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City | ENCINITAS
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State | CA
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Zip | 92024-5142
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Country | US
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Telephone | 760-230-2251
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Fax | 760-230-2253
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Provider Business Mailing Address
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Address Line | PO BOX 231189
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City | ENCINITAS
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State | CA
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Zip | 92023-1189
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Country | US
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Telephone | 760-230-2251
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Fax | 760-230-2253
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD MACCORMICK
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Credential | M.D.
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Telephone | 760-230-2251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 17910
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License Number State | CA
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