Individual provider Active NPI

Daniel David Courson, MS, PA-C

  • Medical Physician Assistant
  • San Diego, CA
National Provider Identifier
1083716518
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 15531 Issued in CA
Practice address
5575 Ruffin Rd Ste 100
San Diego, CA 92123-1361
Phone
(858) 277-2744
NPI assigned
Sep 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PA 15531 CA Primary

Addresses

Primary practice location

5575 Ruffin Rd Ste 100
San Diego, CA 92123-1361

Mailing address

1713 Marson St
Oceanside, CA 92054-2233
Phone (760) 622-7593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PA 15531CAMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083716518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 MARSON ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920542233",
            "telephone_number": "760-622-7593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 RUFFIN RD STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231361",
            "telephone_number": "858-277-2744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURSON",
        "first_name": "DANIEL",
        "middle_name": "DAVID",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA 15531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.