Active NPI
Peter Sotornik, M.D.
- Family Medicine Physician
- San Diego, CA
National Provider Identifier
1184704868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A38541
- Practice address
- 10935 Viacha Dr
San Diego, CA 92124-3422 - Phone
- (858) 694-0252
- Fax
- (858) 694-0252
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A38541 | CA | Primary |
Addresses
Primary practice location
10935 Viacha Dr
San Diego, CA 92124-3422
Mailing address
10935 Viacha Dr
San Diego, CA 92124-3422
Phone (858) 694-0252
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040302001409 | CA | Practitioner - Family Practice | 6002703139 | Practice locations: San Diego, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1976
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
10935 Viacha Dr
San Diego, CA 92124-3422
Phone (858) 541-1155
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38541 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184704868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10935 VIACHA DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921243422",
"telephone_number": "858-694-0252",
"fax_number": "858-694-0252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10935 VIACHA DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921243422",
"telephone_number": "858-694-0252",
"fax_number": "858-694-0252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTORNIK",
"first_name": "PETER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A38541",
"primary": true
}
],
"identifiers": [],
"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 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.