Individual provider Active NPI

Stephen M Daquino, DO

  • Sports Medicine (Family Medicine) Physician
  • San Diego, CA
National Provider Identifier
1346351665
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
20A8442 Issued in CA
Practice address
16445 Bernardo Center Dr
San Diego, CA 92128-2523
Phone
(858) 429-0099
Fax
(866) 266-8027
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 20A8442 CA Primary

Addresses

Primary practice location

16445 Bernardo Center Dr
San Diego, CA 92128-2523

Mailing address

16445 Bernardo Center Dr
San Diego, CA 92128-2523
Phone (858) 429-0099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2025 through Jul 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A8442CAMDSports Medicine (Family Medicine) Physician
8442CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Diego Spine and Wellness Center CurrentSince Jun 21, 2020 Accepting new patients
Floyd County Memorial Hospital Commission Sports Medicine Past Accepting new patients

Locations

16870 W Bernardo Dr
Ste 120
San Diego, CA 92127
Phone (858) 429-0099

16730 Bernardo Center Dr
San Diego, CA 92128
Phone (858) 676-1166

16445 Bernardo Center Dr
San Diego, CA 92128
Phone (858) 429-0099

Organizations & group practices 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1346351665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16445 BERNARDO CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282523",
            "telephone_number": "858-429-0099",
            "fax_number": "866-266-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16445 BERNARDO CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282523",
            "telephone_number": "858-429-0099",
            "fax_number": "866-266-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAQUINO",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A8442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.