Individual provider Active NPI

Elizabeth Ruth Hudler, MD

  • Psychiatry Physician
  • Del Mar, CA
National Provider Identifier
1134287352
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A78721 Issued in CA
Practice address
1125 Camino del Mar Ste F
Del Mar, CA 92014-2645
Phone
(858) 208-3280
Fax
(858) 605-4595
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A78721 CA Primary

Addresses

Primary practice location

1125 Camino del Mar Ste F
Del Mar, CA 92014-2645

Mailing address

1125 Camino del Mar Ste F
Del Mar, CA 92014-2645
Phone (858) 208-3280

Other identifiers 1

IdentifierTypeStateIssuer
00A787210MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabeth R. Hudler, M.D. Apc Psychiatry CurrentSince Dec 15, 2019 Accepting new patients
Psychiatric Centers at San Diego, Inc. Med GRP Past Accepting new patients
Jason R. Kornberg, M.D., a Professional Corporation Psychiatry Past Accepting new patients
Emergency and Acute Care Medical Corporation PastSince Jan 14, 2024 Accepting new patients

Locations

1125 Camino del Mar
Ste F
Del Mar, CA 92014
Phone (858) 208-3280

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1134287352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 CAMINO DEL MAR STE F",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920142645",
            "telephone_number": "858-208-3280",
            "fax_number": "858-605-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 CAMINO DEL MAR STE F",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920142645",
            "telephone_number": "858-208-3280",
            "fax_number": "858-605-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDLER",
        "first_name": "ELIZABETH",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A78721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A787210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Del Mar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; 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.