MEDICARE: SOUTH BAY OB/GYN MEDICAL GROUP, INC.

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
1	174400000X	Specialist

General Provider Information

NPI Number	:	1588651426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH BAY OB/GYN MEDICAL GROUP, INC.

Provider Business Mailing Address
First Line	:	655 EUCLID AVE
Second Line	:	409
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-2957
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	655 EUCLID AVE
Second Line	:	409
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-2957
Country	:	US
Telephone Number	:	619-267-8313
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JACQUIE TRACEY
Credential	:
Telephone Number	:	619-267-8313

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1407851041 — DR. TAGUMPAY E. SACAMAY M.D.
Practice Location Address:

655 EUCLID AVE , STE 303
NATIONAL CITY, CA
91950-2957

Practice Phone: 619-475-4900
Practice Fax: 619-475-8373

1306846498 — EDWIN B FULLER MD
Practice Location Address:

655 EUCLID AVE , SUITE 301
NATIONAL CITY, CA
91950-2957

Practice Phone: 619-267-3020
Practice Fax: 619-267-4042

1245231174 — DR. VALERIE CYNTHIA ALTAVAS M.D.
Practice Location Address:

655 EUCLID AVE , SUITE 302 304
NATIONAL CITY, CA
91950-2957

Practice Phone: 619-472-4575
Practice Fax: 619-472-4530

1366427734 — PARADISE FAMILY HEALTH CENTER
Practice Location Address:

655 EUCLID AVE , SUITE #207
NATIONAL CITY, CA
91950-2957

Practice Phone: 619-475-4575
Practice Fax:

1437181989 — HARRY R BOFFMAN JR.
Practice Location Address:

655 EUCLID AVE , SUITE 301
NATIONAL CITY, CA
91950-2957

Practice Phone: 619-267-3020
Practice Fax: 619-267-4042

1275541625 — MS. MARILES F VALENCIA M.D.
Practice Location Address:

655 EUCLID AVE , #207
NATIONAL CITY, CA
91950-2957

Practice Phone: 619-472-4575
Practice Fax: 619-472-4530

Directions to “SOUTH BAY OB/GYN MEDICAL GROUP, INC. ” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.