Active NPI
Brian Dewhirst
- Physician Assistant
- San Diego, CA
National Provider Identifier
1275039703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA55961
- Practice address
- 3350 La Jolla Village Dr
San Diego, CA 92161-1801 - Phone
- (858) 642-3841
- NPI assigned
- Apr 3, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA55961 | CA | Primary |
Addresses
Primary practice location
3350 La Jolla Village Dr
San Diego, CA 92161-1801
Mailing address
1901 W Lugonia Ave Ste 230
Redlands, CA 92374-9705
Other practice location 1
400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-3390
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA55961 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scripps Health | Current | Accepting new patients |
Interoperability endpoints
- bdewhirst379526@scrippshlth.medalliesdirect.net
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- San Diego, CA
- NPI 1487928891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721088000000",
"number": "1275039703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 W LUGONIA AVE STE 230",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923749705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3350 LA JOLLA VILLAGE DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921611801",
"telephone_number": "858-642-3841"
}
],
"practiceLocations": [
{
"address_1": "400 N Pepper Ave",
"address_purpose": "LOCATION",
"city": "Colton",
"state": "CA",
"postal_code": "923241801",
"country_code": "US",
"telephone_number": "909-580-3390",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEWHIRST",
"first_name": "BRIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-03",
"last_updated": "2024-07-16",
"certification_date": "2024-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA55961",
"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 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.