Individual provider Active NPI

Gregory David Weygandt, DO

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1336728559
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A20464 Issued in CA
Practice address
4094 4TH Ave
San Diego, CA 92103-2143
Phone
(619) 515-2545
NPI assigned
Apr 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A20464 CA Primary

Addresses

Primary practice location

4094 4TH Ave
San Diego, CA 92103-2143

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541

Other practice location 1

5454 El Cajon Blvd
San Diego, CA 92115-3621
Phone (619) 515-2400

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
I20240424003534 CA Practitioner - Family Practice 8022458074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Centers of San Diego IncGroup PAC ID 3476446378, 299 clinicians

Practice addresses (Care Compare)

4065 3Rd Ave
San Diego, CA 92103-2184
Phone (619) 515-2545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A20464CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego Inc CurrentSince Mar 18, 2024 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Mar 18, 2024 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients

Locations

5454 El Cajon Blvd
San Diego, CA 92115
Phone (619) 515-2381

4094 4th Ave
San Diego, CA 92103
Phone (619) 515-2545

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1336728559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4094 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032143",
            "telephone_number": "619-515-2545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5454 El Cajon Blvd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921153621",
            "country_code": "US",
            "telephone_number": "619-515-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEYGANDT",
        "first_name": "GREGORY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A20464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.