Provider Demographics
NPI:1538993175
Name:MKG MEDICAL NETWORK ASSISTANCE LLC
Entity type:Organization
Organization Name:MKG MEDICAL NETWORK ASSISTANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SALVADOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-482-7011
Mailing Address - Street 1:333 H ST STE 5000
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-5561
Mailing Address - Country:US
Mailing Address - Phone:619-988-6512
Mailing Address - Fax:
Practice Address - Street 1:C 14
Practice Address - Street 2:SAN JOSE MERCED
Practice Address - City:SAN JOSE
Practice Address - State:SAN JOSE
Practice Address - Zip Code:10103
Practice Address - Country:CR
Practice Address - Phone:619-988-6512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No3416L0300XTransportation ServicesAmbulanceLand Transport
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No291U00000XLaboratoriesClinical Medical Laboratory
No3336C0002XSuppliersPharmacyClinic Pharmacy