| NPI | 1164483723 |
|---|---|
| Doing Business As | SURFSIDE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | EVANNE WILKEY Practice Director 760-941-4498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A113589) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G65272) |
| 208000000X Pediatrics (Licence: CA G28877) | |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA19297) | |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA15228) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2025-01-07 |