OrganizationMinuteclinic Diagnostic Medical Group Of San Diego IncNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2760 Fletcher Pkwy, El Cajon, CA 92020-2110(866) 389-2727PECOS EnrollmentBased on the most recent information from CMS, provider Minuteclinic Diagnostic Medical Group Of San Diego Inc 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 yesterday at 12:57 PM.Profile DetailsProvider ID1568659233Provider TypeOrganizationFull NameMinuteclinic Diagnostic Medical Group Of San Diego IncSubpartNoEnumeration Date9/26/2007Last Updated10/11/2024Contact InformationPractice LocationPractice Address2760 Fletcher Pkwy, El Cajon, CA 92020-2110Phone(866) 389-2727Fax(401) 406-3539Mailing LocationMailing AddressPO Box 772, Credentialing-Mc 2295, Woonsocket, RI 02895-0784Phone(866) 389-2727Fax(401) 406-3539Authorized OfficialNamePincince, Deborah (Administrator)Phone(401) 770-3813Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted IssuerCode101YP2500XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode1041C0700XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode106H00000XDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted Issuer