Individual provider Active NPI

Thanos George Rossopoulos, MD

  • Psychiatry Physician
  • San Ysidro, CA
National Provider Identifier
1174106835
Registry record updated Jul 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A182392 Issued in CA
Practice address
1666 Precision Park LN
San Ysidro, CA 92173-1346
Phone
(619) 662-4100
Fax
(619) 600-4870
NPI assigned
Apr 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A182392 CA Primary
Family Medicine Physician 207Q00000X A182392 CA

Addresses

Primary practice location

1666 Precision Park LN
San Ysidro, CA 92173-1346

Mailing address

200 Dickinson
MC 8218
San Diego, CA 92103

Other practice location 1

1809 National Ave
San Diego, CA 92113-2113
Phone (619) 515-2300

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
I20230831000160 CA Practitioner - Psychiatry 7214390780 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A182392CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego Inc CurrentSince Jan 6, 2025 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Jan 6, 2025 Accepting new patients
Community Research Foundation Inc CurrentSince Jul 8, 2023 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients

Locations

1196 Third Ave
Chula Vista, CA 91911
Phone (619) 426-7849

545 Laurel St
San Diego, CA 92101
Phone (619) 233-4399

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

1202 Morena Blvd
Ste 300
San Diego, CA 92110
Phone (619) 276-8112

1202 Morena Blvd
Ste 100
San Diego, CA 92110
Phone (619) 276-8112

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

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, 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": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785024000000",
    "number": "1174106835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DICKINSON",
            "address_2": "MC 8218",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 PRECISION PARK LN",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921731346",
            "telephone_number": "619-662-4100",
            "fax_number": "619-600-4870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1809 National Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921132113",
            "country_code": "US",
            "telephone_number": "619-515-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSSOPOULOS",
        "first_name": "THANOS",
        "middle_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-30",
        "last_updated": "2026-07-26",
        "certification_date": "2026-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A182392",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A182392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ysidro, CA

Sources for this page

Verify at the official NPI Registry.