Individual provider Active NPI

Kevin Bernard Calhoun, M.D.

  • Emergency Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1144239401
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G83498 Issued in CA
Practice address
751 Medical Center CT
Chula Vista, CA 91911-6617
Phone
(619) 482-5825
NPI assigned
Aug 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G83498 CA Primary

Addresses

Primary practice location

751 Medical Center CT
Chula Vista, CA 91911-6617

Mailing address

2100 Powell St
Suite 900
Emeryville, CA 94608-1826
Phone (510) 350-2777

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
I20160404000801 CA Practitioner - General PracticePractitioner - Emergency Medicine 6901103548

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G83498CAMDEmergency Medicine Physician
10482RLAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Healthcare Center CurrentSince Aug 12, 2020 Accepting new patients
Workmed California, Apc Past Accepting new patients

Locations

22330 Hawthorne Blvd
Ste J
Torrance, CA 90505
Phone (310) 375-7599

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22871/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144239401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 MEDICAL CENTER CT",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116617",
            "telephone_number": "619-482-5825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALHOUN",
        "first_name": "KEVIN",
        "middle_name": "BERNARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G83498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.