Legacy Medical Group, Inc.
NPI 1083112247ActiveOrganization· Clinic/Center, Multi-Specialty· San Diego, CA
Clinic/Center, Multi-Specialty in San Diego, California, registered in NPPES in January 2018. The authorized official on file is Ralph Hernandez, Executive Director.
Overview
| NPI | 1083112247 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 23, 2018 |
| Last updated in NPPES | Feb 20, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center, Multi-Specialty Primary | 261QM1300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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