Individual provider Active NPI

Mona Ambika Bagrodia, M.D

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1336381193
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C174772 Issued in CA
Practice address
4275 Mission Bay Dr Ste 103
San Diego, CA 92109-5775
Phone
(619) 222-1253
Fax
(858) 795-1195
NPI assigned
Mar 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C174772 CA Primary
Pediatrics Physician 208000000X P2951 TX

Addresses

Primary practice location

4275 Mission Bay Dr Ste 103
San Diego, CA 92109-5775

Mailing address

9850 Genesee Ave Ste 320
La Jolla, CA 92037-1208
Phone (858) 554-1212

Other names 1

  • Mona Ambika Gupta Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250522002177 CA Practitioner - Pediatric Medicine 0345769378 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C174772CAMDPediatrics Physician
P2951TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monica Perlman MD Inc. CurrentSince Jun 25, 2025 Accepting new patients
Lake Ray Hubbard Pediatrics Pediatrics Past Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients
Monica Perlman MD Inc. Pediatrics PastSince Jun 9, 2024 Accepting new patients

Locations

9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800

3737 Moraga Ave
Ste B103
San Diego, CA 92117
Phone (858) 799-0855

4645 Carmel Mountain Rd
Ste 204
San Diego, CA 92130

Organizations & group practices 4

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": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1336381193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE STE 320",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371208",
            "telephone_number": "858-554-1212",
            "fax_number": "858-795-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 MISSION BAY DR STE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921095775",
            "telephone_number": "619-222-1253",
            "fax_number": "858-795-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGRODIA",
        "first_name": "MONA",
        "middle_name": "AMBIKA",
        "name_prefix": "Mrs.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-25",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C174772",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P2951",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONA",
            "last_name": "GUPTA",
            "middle_name": "AMBIKA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.