Rd Dipp DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

20A8075 Issued in CA

Legal business name

RD DIPP DO

Practice address

1350 Columbia St
Unit 800
San Diego, CA 92101-3454

Phone

(619) 255-1649

Fax

(619) 255-1649

NPI assigned

Apr 24, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Randolf Dwight Dipp, DONPI 1134109291

Title

President

Phone

(619) 244-4420

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Randolf Dwight Dipp, D.O.

  • Psychiatry Physician
  • San Diego, CA
  • NPI 1134109291
  Medicare reassignment Care Compare group Authorized official
• Zohreh Kermani, PSY.D

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1538574645
  Medicare reassignment Care Compare group
• Klaudia Monika Mayer, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
  • NPI 1265874473
  Medicare reassignment NPD

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

{
    "created_epoch": "1461456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1003261355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 COLUMBIA ST",
            "address_2": "UNIT 800",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013454",
            "telephone_number": "619-255-1649",
            "fax_number": "619-942-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 COLUMBIA ST",
            "address_2": "UNIT 800",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013454",
            "telephone_number": "619-255-1649",
            "fax_number": "619-255-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RD DIPP DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-24",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A",
        "authorized_official_last_name": "DIPP",
        "authorized_official_first_name": "RANDOLF",
        "authorized_official_middle_name": "DWIGHT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-244-4420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A8075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Raied Razooky
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• RBRK Healthcare LLC
• Matthew Cameron Re, M.D.
• Giselle Diaz Rea, ED.S
• Jessica Brooke Rea, CMT, CMLDT
• Martha Alicia Rea
• Parker Rea, MD

• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.