Organization Active NPI

Ronald Nino M Perez M D PC

  • Family Medicine Physician
  • Carlsbad, CA
National Provider Identifier
1336679356
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RONALD NINO M PEREZ M D PC
Doing business as
My Family Doc
Practice address
1207 Carlsbad Village Dr Ste a
Carlsbad, CA 92008-1958
Phone
(760) 896-3030
Fax
(760) 896-3033
NPI assigned
Jun 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Ronald Nino M Perez, MDNPI 1295967594
Title
MD
Phone
(760) 896-3030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1207 Carlsbad Village Dr Ste a
Carlsbad, CA 92008-1958

Mailing address

2604-B El Camino Real
#261
Carlsbad, CA 92008
Phone (760) 896-3030

Other names 1

  • My Family Doc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190430002208 CA Part B Supplier - Clinic/Group Practice 4981975703 Receives reassigned benefits from 1 practitioner
Practice locations: Carlsbad, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2164156My Family Doc1207 Carlsbad Village Drive, Suite a, Carlsbad, CA 92008Certificate of waiverMar 27, 2027

National Provider Directory

National Provider Directory

Locations

1207 Carlsbad Village Dr
Ste A
Carlsbad, CA 92008
Phone (760) 434-7374

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1336679356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604-B EL CAMINO REAL",
            "address_2": "#261",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "92008",
            "telephone_number": "760-896-3030",
            "fax_number": "760-896-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 CARLSBAD VILLAGE DR STE A",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081958",
            "telephone_number": "760-896-3030",
            "fax_number": "760-896-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD NINO M PEREZ M D PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-13",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "RONALD NINO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "760-896-3030",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Family Doc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.