Stephen M. Daquino, DO; Inc

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

20A8442 Issued in CA

Legal business name

STEPHEN M. DAQUINO, DO; INC

Doing business as

Revivify Restorative Medicine
Strive Sports & Family Medicine

Practice address

16445 Bernardo Center Dr
San Diego, CA 92128-2523

Phone

(858) 429-0099

Fax

(858) 676-1172

NPI assigned

Aug 17, 2012

Last updated

Jul 29, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stephen M Daquino, DONPI 1346351665

Title

Medical Director

Phone

(858) 429-0099

Specialties & licenses 1

Addresses

Other names 2

• Revivify Restorative Medicine Doing business as
• Strive Sports & Family Medicine Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen M Daquino, DO

  • Sports Medicine (Family Medicine) Physician
  • San Diego, CA
  • NPI 1346351665
  Authorized official Same address or phone
• James Lawrence Padilla, D.C.

  • Chiropractor
  • San Diego, CA
  • NPI 1932206083
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1003164385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16445 BERNARDO CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282523",
            "telephone_number": "858-429-0099",
            "fax_number": "866-266-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16445 BERNARDO CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282523",
            "telephone_number": "858-429-0099",
            "fax_number": "858-676-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN M. DAQUINO, DO; INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-17",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "DAQUINO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "858-429-0099",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A8442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revivify Restorative Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Strive Sports & Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephen a. Luskin Optometric Corporation
• Stephen C. Tuttle, DDS, a Propfessional Corporation
• Stephen Chinn
• Stephen Chinn OD a Professional Corperation Dba As Stephen Chinn OD (Stephen Chinn OD)
• Stephen G. Ward, D.D.S. Dental Corporation
• Stephen Wagers, D.P.M., a.P.C.
• Amy L. Stephen, MSW, LCSW
• Janetta Sue Stephen, LMFT
• Michael Ledell Stephen Jr., RADT
• Stephens Dental

• Sports Medicine (Family Medicine) Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Sports Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.