MEDICARE: DEL RE MEDICAL CORP

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	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1962361105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEL RE MEDICAL CORP

Provider Business Mailing Address
First Line	:	315 S COAST HIGHWAY 101 STE U148
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-3543
Country	:	US
Telephone Number	:	843-834-0100
Fax Number	:

Provider Business Practice Location Address
First Line	:	9333 GENESEE AVE STE 250
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-2139
Country	:	US
Telephone Number	:	858-215-1144
Fax Number	:	760-257-1951

Authorized Official
Title or Position	:	PHYSICIAN/DIRECTOR/OWNER
Name	:	DR. ANGELO MICHAEL DEL RE
Credential	:	MD
Telephone Number	:	843-834-0100

Provider Enumeration Date	:	01/21/2026
Last Update Date	:	01/21/2026

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Directions to “DEL RE MEDICAL CORP ” Practice Location

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