NPIMap

Organization Active NPI

Carlos F Jimenez, MD

  • Otolaryngology Physician
  • Chula Vista, CA
National Provider Identifier
1104914696
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G46465 Issued in CA
Legal business name
CARLOS F JIMENEZ, MD
Practice address
321 E St Ste a
Chula Vista, CA 91910-2667
Phone
(619) 934-3260
Fax
(619) 934-3268
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Authorized official

Name
Carlos F Jimenez, MD
Title
Owner
Phone
(619) 934-3260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X G46465 CA Primary

Addresses

Primary practice location

321 E St Ste a
Chula Vista, CA 91910-2667

Mailing address

321 E St Ste a
Chula Vista, CA 91910-2667
Phone (619) 934-3260

Other identifiers 1

IdentifierTypeStateIssuer
GR0094210MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1104914696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 E ST STE A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102667",
            "telephone_number": "619-934-3260",
            "fax_number": "619-934-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 E ST STE A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102667",
            "telephone_number": "619-934-3260",
            "fax_number": "619-934-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS F JIMENEZ, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-934-3260",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G46465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0094210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.