Individual provider Active NPI

Miguel Trujillo, PA-C

  • Physician Assistant
  • San Bernardino, CA
National Provider Identifier
1285806794
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15656 Issued in CA
Practice address
685 Carnegie Dr Ste 230
San Bernardino, CA 92408-3583
Phone
(909) 890-0407
Fax
(909) 890-0575
NPI assigned
Mar 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA15656 CA Primary

Addresses

Primary practice location

685 Carnegie Dr Ste 230
San Bernardino, CA 92408-3583

Mailing address

29361 Clear View LN
Highland, CA 92346-5442
Phone (909) 425-9165

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121228000178 CA Practitioner - Physician Assistant 9436302320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 Town Ctr Pkwy
Santee, CA 92071-5801
Phone (619) 662-4100

1637 3Rd Ave
Suite B
Chula Vista, CA 91911-5823
Phone (619) 662-4100

1666 Precision Park LN
San Diego, CA 92173-1346
Phone 61966241001466

2400 E 8TH St
Suite a
National City, CA 91950-2956
Phone (619) 662-4100

292 Euclid Ave
Suite 210
San Diego, CA 92114-3629
Phone (619) 662-4100

316 25TH St
San Diego, CA 92102-3016
Phone (619) 662-4100

3177 Ocean View Blvd
San Diego, CA 92113-1432
Phone (619) 662-4100

330 -340 E 8TH St
National City, CA 91950-2312
Phone (619) 662-4100

4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 428-4463

4050 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 662-4100

4690 El Cajon Blvd
San Diego, CA 92115-4403
Phone (619) 662-4100

678 3Rd Ave
Chula Vista, CA 91910-5736
Phone (619) 662-4100

950 S Euclid Ave
San Diego, CA 92114-6201
Phone (619) 662-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Jul 11, 2014 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Jul 11, 2014 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Past Accepting new patients
Rady Children'S Hospital San Diego Past Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

316 25th St
San Diego, CA 92102
Phone (619) 234-1365

4004 Beyer Blvd
San Ysidro, CA 92173
Phone (619) 428-1330

1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585

120 Town Center Pkwy
Santee, CA 92071
Phone (619) 645-0111

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mtrujillo18951@syhealth.direct-ci.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1285806794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29361 CLEAR VIEW LN",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923465442",
            "telephone_number": "909-425-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 CARNEGIE DR STE 230",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083583",
            "telephone_number": "909-890-0407",
            "fax_number": "909-890-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "MIGUEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-25",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.