Individual provider Active NPI

Diana Marquardt, MD

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1114909454
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MDG44220 Issued in CA
Practice address
4290 Polk Ave
San Diego, CA 92105-1524
Phone
(619) 563-0507
Fax
(619) 563-0015
NPI assigned
Nov 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MDG44220 CA Primary

Addresses

Primary practice location

4290 Polk Ave
San Diego, CA 92105-1524

Mailing address

4290 Polk Ave
San Diego, CA 92105-1524
Phone (619) 563-0507

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
I20101201000254 CA Practitioner - Internal Medicine 3375739410 Practice locations: San Diego, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44220CAMDMarriage & Family Therapist
MDG44220CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114909454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 POLK AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051524",
            "telephone_number": "619-563-0507",
            "fax_number": "619-563-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 POLK AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051524",
            "telephone_number": "619-563-0507",
            "fax_number": "619-563-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUARDT",
        "first_name": "DIANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "MDG44220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.