CASSIDY MEDICAL GROUP - SW NPI 1093882359

NPI Information

  • NPI: 1093882359
  • Provider Name: CASSIDY MEDICAL GROUP - SW
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 2095 W VISTA WAY STE 218
    VISTA, CA
    ZIP 92083
  • Phone: (760) 630-3562

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NPI Details

CASSIDY MEDICAL GROUP - SW is a family medicine in Vista, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CASSIDY MEDICAL GROUP - SW NPI is 1093882359. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2095 W VISTA WAY STE 218
VISTA, CA
ZIP 92083-029
Phone: (760) 630-3562
Fax: (760) 630-2559

The provider's authorized official is Judith M Krueger .
The authorized official title is Executive Director and has the following contact phone number (760) 630-5487.

The enumeration date for this NPI number is 11/29/2006 and was last updated on 10/13/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CH4627MEDICARE PINCALIFORNIA
23016OTHERCALIFORNIANEIC SITE ID, NSF BA0-7
3GROO60602MEDICAIDCALIFORNIA
4W14833BMEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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