Individual ProviderDerrick Maurice KnoxGeneral PracticeAllopathic & Osteopathic PhysiciansPractice Address34800 Bob Wilson Dr, San Diego, CA 92134-1098(619) 532-5761PECOS EnrollmentBased on the most recent information from CMS, provider Derrick Maurice Knox does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1295480218Provider TypeIndividualFull NameKnox, Derrick MauriceTitleMr.CredentialMDGenderMaleSole ProprietorYesEnumeration Date2/17/2022Last Updated2/22/2024Contact InformationPractice LocationPractice Address34800 Bob Wilson Dr, San Diego, CA 92134-1098Phone(619) 532-5761FaxUnlisted FaxMailing LocationMailing Address34800 Bob Wilson Dr, San Diego, CA 92134-1098Phone(619) 532-5761FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208D00000XPrimaryDescriptionGeneral PracticeAllopathic & Osteopathic PhysiciansLicense0101279387VirginiaCode171000000XDescriptionMilitary Health Care ProviderOther Service ProvidersLicenseUnlisted Issuer