Shadowridge Medical Group

LBN: Shadowridge Medical Group
Shadowridge Medical Group is an health care organization with primary practice located at 1680 S Melrose Dr Ste 105 , Vista CA 92081-5472. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Shadowridge Medical Group can be contacted via phone (760) 727-6920, or through Wine, Todd via phone (760) 727-6920.

Contact Information

Primary practice address
1680 S Melrose Dr Ste 105 Vista CA 92081-5472
Phone: (760) 727-6920
Fax: (760) 727-3368
Website:
Map and Directions
Authorized official contact:
Name: Wine, Todd Doctor of Medicine (MD)
Phone: (760) 727-6920

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X G045531 California

Profile Details

NPI number 1639398613
LBN Legal business name Shadowridge Medical Group
DBA Doing business as
Authorized official Wine, Todd Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 25th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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