OrganizationSan Diego Spine CenterSpecialistOther Service ProvidersPractice Address7920 Frost St Ste 406, San Diego, CA 92123-4298(858) 292-8911PECOS EnrollmentBased on the most recent information from CMS, provider San Diego Spine Center 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 2 days ago.Profile DetailsProvider ID1336354489Provider TypeOrganizationFull NameSan Diego Spine CenterSubpartNoEnumeration Date5/11/2007Last Updated8/22/2020Contact InformationPractice LocationPractice Address7920 Frost St Ste 406, San Diego, CA 92123-4298Phone(858) 292-8911FaxUnlisted FaxMailing LocationMailing Address7920 Frost St Ste 406, San Diego, CA 92123-4298Phone(858) 292-8911FaxUnlisted FaxAuthorized OfficialNameCleary, John (President)Phone(858) 292-8911Provider TaxonomiesCodeDescriptionLicenseCode174400000XPrimaryDescriptionSpecialistOther Service ProvidersLicenseA23315California