Individual provider Active NPI

Elizabeth Ann Dingbaum, PA

  • Medical Physician Assistant
  • Oceanside, CA
National Provider Identifier
1073101564
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
59243 Issued in CA
Practice address
605 Crouch St BLDG C
Oceanside, CA 92054-4415
Phone
(760) 736-6767
Fax
(760) 736-8740
NPI assigned
Jan 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 59243 CA Primary

Addresses

Primary practice location

605 Crouch St BLDG C
Oceanside, CA 92054-4415

Mailing address

150 Valpreda Rd
San Marcos, CA 92069-2973
Phone (760) 736-6767

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210329002297 CA Practitioner - Physician Assistant 9931516499 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
59243CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Share Our Selves Corporation Current Accepting new patients
North County Health Project Inc CurrentSince Jul 7, 2025 Accepting new patients
North County Health Project Inc CurrentSince Jul 7, 2025 Accepting new patients
Share Our Selves Corporation CurrentSince Mar 29, 2021 Accepting new patients
Share Our Selves Corporation CurrentSince Mar 29, 2021 Accepting new patients
North County Health Project Inc Past Accepting new patients

Locations

1550 Superior Ave
Costa Mesa, CA 92627
Phone (949) 650-0186

605 Crouch St
Bldg C
Oceanside, CA 92054
Phone (760) 757-4566

150 Valpreda Rd
San Marcos, CA 92069
Phone (619) 736-6700

Interoperability endpoints

  • Direct secure messaging: edingbaum809068@direct.ochin.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1610150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1073101564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 VALPREDA RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692973",
            "telephone_number": "760-736-6767",
            "fax_number": "760-736-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 CROUCH ST BLDG C",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920544415",
            "telephone_number": "760-736-6767",
            "fax_number": "760-736-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINGBAUM",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-09",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "59243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.