Individual provider Active NPI

Amir Reza Djavid, MD

  • Dermatology Physician
  • Chula Vista, CA
National Provider Identifier
1023758091
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A193395 Issued in CA
Practice address
1400 E Palomar St
Chula Vista, CA 91913-1800
Phone
(619) 397-3295
NPI assigned
Mar 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A193395 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1400 E Palomar St
Chula Vista, CA 91913-1800

Mailing address

1400 E Palomar St
Chula Vista, CA 91913-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5651 Copley Dr
San Diego, CA 92111-7903

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1023758091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E PALOMAR ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E PALOMAR ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131800",
            "telephone_number": "619-397-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJAVID",
        "first_name": "AMIR",
        "middle_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-29",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A193395",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.