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NPI Code Detail

MEDICARE: DESTINATIONS DIRECT PRIMARY CARE

MEDICARE: DESTINATIONS DIRECT PRIMARY CARE
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician
2207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1346811882
Entity Type Code : Organization
Provider Name (Legal Business Name) : DESTINATIONS DIRECT PRIMARY CARE
Provider Business Mailing Address
First Line : 338 VIA VERA CRUZ STE 100
Second Line :
City : SAN MARCOS
State : CA
Zip : 92078-2645
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 338 VIA VERA CRUZ STE 100
Second Line :
City : SAN MARCOS
State : CA
Zip : 92078-2645
Country : US
Telephone Number : 304-741-3523
Fax Number :
Authorized Official
Title or Position : MD/CEO
Name : DR. JOHN C NEELY
Credential : MD
Telephone Number : 304-741-3523
Provider Enumeration Date : 07/06/2021
Last Update Date : 07/06/2021

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Directions to “DESTINATIONS DIRECT PRIMARY CARE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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