Active NPI
Charles Theuer, MD
- Surgery Physician
- San Diego, CA
National Provider Identifier
1376185116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- G070310
- Practice address
- 4350 La Jolla Village Dr Ste 800
San Diego, CA 92122-1247 - Phone
- (858) 251-3490
- NPI assigned
- Oct 14, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | G070310 | CA | Primary |
Addresses
Primary practice location
4350 La Jolla Village Dr Ste 800
San Diego, CA 92122-1247
Mailing address
4350 La Jolla Village Dr Ste 800
San Diego, CA 92122-1247
Phone (858) 251-3490
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G070310 | CA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571011200000",
"number": "1376185116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4350 LA JOLLA VILLAGE DR STE 800",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921221247",
"telephone_number": "858-251-3490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4350 LA JOLLA VILLAGE DR STE 800",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921221247",
"telephone_number": "858-251-3490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEUER",
"first_name": "CHARLES",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-14",
"last_updated": "2019-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "G070310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.