MEDICARE: NUCLEUS MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	207RC0000X	Cardiovascular Disease Physician
3	207SG0201X	Clinical Genetics (M.D.) Physician
4	208000000X	Pediatrics Physician
5	2085B0100X	Body Imaging Physician
6	2085R0202X	Diagnostic Radiology Physician
7	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1003402264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUCLEUS MEDICAL GROUP

Provider Business Mailing Address
First Line	:	4570 EXECUTIVE DR STE 100
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3074
Country	:	US
Telephone Number	:	844-838-3322
Fax Number	:

Provider Business Practice Location Address
First Line	:	4570 EXECUTIVE DR STE 100
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3074
Country	:	US
Telephone Number	:	844-838-3322
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID KAROW
Credential	:	MD
Telephone Number	:	858-361-5779

Provider Enumeration Date	:	12/11/2020
Last Update Date	:	11/16/2023

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Directions to “NUCLEUS MEDICAL GROUP ” Practice Location

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