Basic Information
| Provider Information | |||||||||
| NPI: | 1841696978 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NORTH COUNTY HEALTH SERVICES | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 150 VALPREDA RD | ||||||||
| Address2: | |||||||||
| City: | SAN MARCOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920692973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607366700 | ||||||||
| FaxNumber: | 7607368740 | ||||||||
| Practice Location | |||||||||
| Address1: | 150 VALPREDA RD | ||||||||
| Address2: | |||||||||
| City: | SAN MARCOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920692973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607366700 | ||||||||
| FaxNumber: | 7607368740 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2014 | ||||||||
| LastUpdateDate: | 11/18/2014 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | ROMNEY | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | HEAD DENTIST | ||||||||
| AuthorizedOfficialTelephone: | 7607366700 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | DDS | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 302R00000X | 48692 | CA | Y | Managed Care Organizations | Health Maintenance Organization |
No ID Information.