Mario Eduardo Eyzaguirre, M.D.

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

A42572 Issued in CA

Practice address

4077 5TH Ave
San Diego, CA 92103-2105

Phone

(619) 260-7046

Fax

(619) 686-3843

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Clinica Medica Pediatrica Inc

  • Pediatric Critical Care Medicine Physician
  • San Diego, CA
  • NPI 1649451493
  NPD (past) Authorized official
• San Diego Pediatrics & Family Medical Clinic

  • General Practice Physician
  • Chula Vista, CA
  • NPI 1265443444
  NPD (past) Authorized official

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205866258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 SANDBURG AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921224132",
            "telephone_number": "619-260-7046",
            "fax_number": "619-686-3843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4077 5TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032105",
            "telephone_number": "619-260-7046",
            "fax_number": "619-686-3843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYZAGUIRRE",
        "first_name": "MARIO",
        "middle_name": "EDUARDO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "A42572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eyelux Optometry
• Eyes for Kids and Teens
• Eyesmith, a Professional Optometry Corporation
• Eyexam of California Inc
• Lisa Todd Eyler, PH.D.
• Ikemefuna Ikem Ezedi, DO
• Sean Michael Ezell, DPT
• Ebenezer Ezenwa
• Njideka C. Ezeokoli, MD
• Ifunanya Joy Ezimora

• Pediatric Critical Care Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Pediatric Critical Care Medicine Physician in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.