Edward Jaesung Ahn, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A38304 Issued in CA

Practice address

7750 Dagget St Ste 108
San Diego, CA 92111-2235

Phone

(858) 571-1004

Fax

(858) 571-1006

NPI assigned

Oct 13, 2006

Last updated

Aug 2, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

General Practice

Education

Other, 1964

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

• Harvard Medical Group Inc

  • General Practice Physician
  • San Diego, CA
  • NPI 1023225455
  Medicare reassignment NPD Authorized official
• Scripps Health

  dba Scripps Mercy Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1093805103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7750 DAGGET ST STE 108",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112235",
            "telephone_number": "858-571-1004",
            "fax_number": "858-571-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7750 DAGGET ST STE 108",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112235",
            "telephone_number": "858-571-1004",
            "fax_number": "858-571-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "EDWARD",
        "middle_name": "JAESUNG",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A38304",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A38304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00Q383040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Safi Ahmed, M.D., M.P.H.
• Sarah Farukhi Ahmed, M.D
• Tahmid Ahmed
• Ahmedo Dental Inc.
• Michael Ahmu, RRT
• Hyunah Ahn, M.D.
• Jennifer Ahn, M.D.
• Jennifer Young Ahn, PHARMD
• Jordan Louie Ahn
• Kevin Ahn

• General Practice Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.