Provider Demographics
NPI:1144644170
Name:ARTEMIS MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:ARTEMIS MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VISHAAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-278-3647
Mailing Address - Street 1:770 WASHINGTON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2209
Mailing Address - Country:US
Mailing Address - Phone:858-278-3636
Mailing Address - Fax:858-278-3637
Practice Address - Street 1:770 WASHINGTON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2209
Practice Address - Country:US
Practice Address - Phone:858-278-3636
Practice Address - Fax:858-278-3637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X
CAA67412103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty