Individual provider Active NPI

Kamala Vaidya, M.D.

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1083840920
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A124814 Issued in CA
Practice address
3020 Childrens Way # Mc5075
San Diego, CA 92123-4223
Phone
(858) 576-1700
NPI assigned
Jun 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A124814 CA Primary
Pediatrics Physician 208000000X 8536A WY

Addresses

Primary practice location

3020 Childrens Way # Mc5075
San Diego, CA 92123-4223

Mailing address

3020 Childrens Way # Mc5075
San Diego, CA 92123-4223
Phone (858) 966-8036

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
I20150318001829 CA Practitioner - Pediatric Medicine 3375860042 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A124814CAMDPediatrics Physician
8536AWYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rady Children'S Hospital San Diego CurrentSince Jan 1, 2015 Accepting new patients
Rady Children'S Hospital San Diego Pediatrics CurrentSince Jan 1, 2015 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients

Locations

386 E H St
Ste 202
Chula Vista, CA 91910
Phone (619) 691-1108

2125 Citracado Pkwy
Ste 100
Escondido, CA 92029
Phone (760) 739-1543

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

3605 Vista Way
Ste 172
Oceanside, CA 92056
Phone (760) 547-1000

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

3020 Childrens Way
#5075
San Diego, CA 92123
Phone (858) 966-8036

3020 Childrens Way
#5001
San Diego, CA 92123
Phone (858) 966-4011

Organizations & group practices 3

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": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1083840920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5075",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-8036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5075",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-576-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAIDYA",
        "first_name": "KAMALA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-05",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A124814",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WY",
            "license": "8536A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.