Provider Demographics
NPI:1144653528
Name:CHECK POINT TRANSITION CLINIC, INC.
Entity type:Organization
Organization Name:CHECK POINT TRANSITION CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:MACCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-230-2252
Mailing Address - Street 1:2611 S COAST HIGHWAY 101
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CARDIFF
Mailing Address - State:CA
Mailing Address - Zip Code:92007-2100
Mailing Address - Country:US
Mailing Address - Phone:760-230-2252
Mailing Address - Fax:760-230-2253
Practice Address - Street 1:320 SANTA FE DR
Practice Address - Street 2:SUITE 308
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5138
Practice Address - Country:US
Practice Address - Phone:760-230-8994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC38688207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC38688OtherMEDICAL LINCENSE