Basic Information
| Provider Information | |||||||||
| NPI: | 1427268747 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHILIP D SZOLD, MD, INC | ||||||||
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| OtherOrganizationName: | LA MESA FAMILY MEDICAL GROUP | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8881 FLETCHER PKWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | LA MESA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919423135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194646434 | ||||||||
| FaxNumber: | 6194645109 | ||||||||
| Practice Location | |||||||||
| Address1: | 8881 FLETCHER PKWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | LA MESA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919423135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194646434 | ||||||||
| FaxNumber: | 6194645109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2007 | ||||||||
| LastUpdateDate: | 05/30/2019 | ||||||||
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| AuthorizedOfficialLastName: | CAYTON | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING MANAGER/ ADMIN | ||||||||
| AuthorizedOfficialTelephone: | 6194646434 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 208000000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | 174400000X | Y | 193200000X MULTI-SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.