| Organization Name: | CENTRO MEDICO DEL CARMEN, A MEDICAL CORPORATION |
| NPI Number: | 1063621738 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS LEE WATSON (CEO) |
| Mailing Address: | 301 E Washington Ave Suite B Escondido |
| State: | CA US |
| Postal Code: | 920252855 |
| Phone Number: | 7604809051 |
| Fax Number: | 7604809054 |
| NPI Enumeration Date: | 05/21/2007 |
| NPI Last Update Date: | 07/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A52193 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |