Individual provider Active NPI

Ahmad Kabakibi, MD

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1043390206
Registry record updated Sep 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A94768 Issued in CA
Practice address
6367 Alvarado CT Ste 200
San Diego, CA 92120-4915
Phone
(619) 583-1954
Fax
(619) 583-5499
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A94768 CA Primary

Addresses

Primary practice location

6367 Alvarado CT Ste 200
San Diego, CA 92120-4915

Mailing address

6367 Alvarado CT Ste 200
San Diego, CA 92120-4915
Phone (619) 583-1954

Other practice location 1

5555 Grossmont Center Dr
LA Mesa, CA 91942-3019
Phone (619) 465-0711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070223000331 CA Practitioner - Internal Medicine 0446352348 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Rawi Medical, PCGroup PAC ID 3678826047, 11 clinicians

Practice addresses (Care Compare)

3525 Del Mar Heights Rd
Suite 359
San Diego, CA 92130-2199
Phone (858) 252-2700

6367 Alvarado CT
Suite 200
San Diego, CA 92120-4915
Phone (619) 583-1954

Hospital & facility affiliations

  • Saint Victoria Home Health Care Home health agency, North Hollywood, CA, CCN 757646
  • Odyssey Home Health Care, Inc. Home health agency, Chatsworth, CA, CCN 757079
  • Good Samaritan Home Health Inc Home health agency, National City, CA, CCN 757272
  • Comfort and Peace Hospice Hospice, San Diego, CA, CCN A01593
  • Grossmont Hospital Hospital, La Mesa, CA, CCN 050026
  • Palomar Medical Center Poway Hospital, Poway, CA, CCN 050636
  • VI at la Jolla Village Nursing home, San Diego, CA, CCN 555793
  • Brighton Place Spring Valley Nursing home, Spring Valley, CA, CCN 055685

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A94768CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Oct 20, 2014 Accepting new patients
DMCK Medical Corporation Internal Medicine CurrentSince Oct 10, 2023 Accepting new patients
Rawi Medical PC CurrentSince Sep 11, 2023 Accepting new patients
Kabakibi Medical Corporation Internal Medicine CurrentSince Aug 23, 2006 Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients

Locations

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

5965 Village Way
Ste E105411
San Diego, CA 92130
Phone (619) 578-1063

4629 Cass St
San Diego, CA 92109
Phone (855) 266-2300

3525 Del Mar Heights Rd
Ste 359
San Diego, CA 92130
Phone (858) 252-2700

6367 Alvarado Ct
Ste 200
San Diego, CA 92120
Phone (619) 583-1954

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

9009 Campo Rd
Spring Valley, CA 91977
Phone (616) 460-2711

Interoperability endpoints

  • Direct secure messaging: akabakibi33913@sharphealthcare.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Brighton Place Spring ValleySpring Valley, CA, CCN 055685 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Sep 1, 2022
Sep 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693612800000",
    "number": "1043390206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6367 ALVARADO CT STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204915",
            "telephone_number": "619-583-1954",
            "fax_number": "619-583-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6367 ALVARADO CT STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204915",
            "telephone_number": "619-583-1954",
            "fax_number": "619-583-5499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5555 Grossmont Center Dr",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919423019",
            "country_code": "US",
            "telephone_number": "619-465-0711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KABAKIBI",
        "first_name": "AHMAD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2023-09-02",
        "certification_date": "2023-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A94768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.