San Diego Urology, Inc

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

SAN DIEGO UROLOGY, INC

Practice address

12650 Sabre Springs Pkwy Ste 204
San Diego, CA 92128-4114

Phone

(714) 856-5472

NPI assigned

Nov 30, 2023

Last updated

Nov 30, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Roseann Gonzalez

Title

Administrator

Phone

(714) 856-5472

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly P. Cockerham, MD

  • Neuro-ophthalmology Physician
  • San Diego, CA
  • NPI 1366493629
  NPD

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1316713332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23052 ALICIA PKWY STE 619",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926921643",
            "telephone_number": "714-856-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12650 SABRE SPRINGS PKWY STE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284114",
            "telephone_number": "714-856-5472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO UROLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ROSEANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "714-856-5472"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• San Diego Unified School District (Riley Day School Services)
• San Diego Unified School District (School Based Skill Building)
• San Diego Unified School District (New Dawn Day School Services)
• San Diego Unified School District Mental Health Resource Center
• San Diego Uptown Pediatric Medical Group, Inc
• San Diego Vamc
• San Diego Vamc
• San Diego Vamc
• San Diego Vamc
• San Diego Vamc

• Medical Specialty Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.