Active NPI
Daniel Gardner, MD
- Psychiatry Physician
- San Diego, CA
National Provider Identifier
1134103591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G27104
- Practice address
- 4550 Kearny Villa Rd
Suite 214
San Diego, CA 92123-1578 - Phone
- (858) 560-5609
- Fax
- (858) 560-5609
- NPI assigned
- Nov 30, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G27104 | CA | Primary |
Addresses
Primary practice location
4550 Kearny Villa Rd
Suite 214
San Diego, CA 92123-1578
Mailing address
13725 Mar Scenic Dr
Del Mar, CA 92014-3426
Phone (858) 560-5609
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G271D40 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 5, 2015 through Dec 5, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1134103591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13725 MAR SCENIC DR",
"city": "DEL MAR",
"state": "CA",
"postal_code": "920143426",
"telephone_number": "858-560-5609",
"fax_number": "858-560-5609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4550 KEARNY VILLA RD",
"address_2": "SUITE 214",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231578",
"telephone_number": "858-560-5609",
"fax_number": "858-560-5609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "DANIEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-30",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G27104",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G271D40",
"state": "CA"
}
],
"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 13, 2026; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.