Individual provider Active NPI

Kelly Michelle Chacon, MD

  • Obstetrics & Gynecology Physician
  • La Jolla, CA
National Provider Identifier
1336608314
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A186207 Issued in CA
Practice address
9300 Campus Point Dr
La Jolla, CA 92037-1300
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Mar 18, 2019
Last updated
Nov 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A186207 CA Primary

Addresses

Primary practice location

9300 Campus Point Dr
La Jolla, CA 92037-1300

Mailing address

File 57326
Los Angeles, CA 90074-7326

Other practice location 1

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273

Other practice location 2

9400 Campus Point Dr
La Jolla, CA 92093-1350
Phone (800) 926-8273

Other practice location 3

9333 Genesee Ave
San Diego, CA 92121-2111
Phone (800) 926-8273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230620001072 CA Practitioner - Obstetrics/Gynecology 9032577374 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A186207CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Obstetrics & Gynecology CurrentSince Apr 9, 2023 Accepting new patients
Regents of the University of California CurrentSince Apr 9, 2023 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

9400 Campus Point Dr
La Jolla, CA 92093
Phone (619) 543-3863

File 57326
Los Angeles, CA 90074

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

9333 Genesee Ave
San Diego, CA 92121
Phone (619) 455-9100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1336608314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57326",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900747326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 CAMPUS POINT DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371300",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9400 Campus Point Dr",
            "address_purpose": "LOCATION",
            "city": "La Jolla",
            "state": "CA",
            "postal_code": "920931350",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9333 Genesee Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921212111",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHACON",
        "first_name": "KELLY",
        "middle_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A186207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.