Active NPI
David P. Dimmock, M.D.
- Clinical Biochemical Genetics Physician
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Biochemical Genetics Physician
- License
- C146669
- Practice address
- 3030 Childrens Way
San Diego, CA 92123-4232 - Phone
- (800) 788-9029
- Fax
- (858) 966-8092
- NPI assigned
- Jul 8, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Genetics (M.D.) Physician | 207SG0201X | C146669 | CA | |
| Pediatrics Physician | 208000000X | C146669 | CA | |
| Clinical Biochemical Genetics Physician | 207SG0202X | C146669 | CA | Primary |
Addresses
Primary practice location
3030 Childrens Way
San Diego, CA 92123-4232
Mailing address
3030 Childrens Way
San Diego, CA 92123-4232
Phone (800) 788-9029
Other practice location 1
9300 Valley Childrens Pl
Madera, CA 93636-8761
Phone (559) 353-6700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275796419 | Medicaid | WI |
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Medical Genetics and Genomics
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1524 McHenry Ave
Modesto, CA 95350-4500
Phone (209) 572-3880
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C146669 | CA | MD | Clinical Biochemical Genetics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Children'S Medical Group | Pediatrics | Current | Accepting new patients |
| University Hospitals Cleveland Medical Center | Past | Accepting new patients |
Locations
9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700
9300 Valley Childrens Pl
#5
Madera, CA 93636
Phone (559) 353-5700
1524 McHenry Ave
Ste 550570
Modesto, CA 95350
Phone (209) 572-3880
Interoperability endpoints
- ddimmock64795@valleychildrens-prd.direct-ci.com
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 and National Provider Directory roles.
-
- Pediatrics Physician
- Modesto, CA
- NPI 1437555265
-
- General Acute Care Hospital
- Cleveland, OH
- NPI 1043397292
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657756800000",
"number": "1275796419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3030 CHILDRENS WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234232",
"telephone_number": "800-788-9029",
"fax_number": "858-966-8092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3030 CHILDRENS WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234232",
"telephone_number": "800-788-9029",
"fax_number": "858-966-8092"
}
],
"practiceLocations": [
{
"address_1": "9300 Valley Childrens Pl",
"address_purpose": "LOCATION",
"city": "Madera",
"state": "CA",
"postal_code": "936368761",
"country_code": "US",
"telephone_number": "559-353-6700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIMMOCK",
"first_name": "DAVID",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-08",
"last_updated": "2022-07-14",
"certification_date": "2022-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "207SG0201X",
"taxonomy_group": "",
"desc": "Medical Genetics, Clinical Genetics (M.D.)",
"state": "CA",
"license": "C146669",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "C146669",
"primary": false
},
{
"code": "207SG0202X",
"taxonomy_group": "",
"desc": "Medical Genetics, Clinical Biochemical Genetics",
"state": "CA",
"license": "C146669",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1275796419",
"state": "WI"
}
],
"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 14, 2022; 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.