Individual provider Active NPI

Mary Abigail Sevilla Garcia, M.D.

  • Pediatric Gastroenterology Physician
  • San Diego, CA
National Provider Identifier
1386805877
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
A89980 Issued in CA
Practice address
8110 Birmingham Way
BLDG 28
San Diego, CA 92123-2758
Phone
(858) 966-4003
NPI assigned
Jun 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A89980 CA
Pediatric Gastroenterology Physician 2080P0206X A89980 CA Primary

Addresses

Primary practice location

8110 Birmingham Way
BLDG 28
San Diego, CA 92123-2758

Mailing address

3860 Calle Fortunada
Suite 210
San Diego, CA 92123-4800
Phone (858) 309-6303

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
I20081210000251 CA Practitioner - GastroenterologyPractitioner - Pediatric Medicine 5395804926 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A89980CAMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rady Children'S Hospital San Diego Pediatrics CurrentSince Mar 26, 2012 Accepting new patients
Rady Children'S Hospital San Diego CurrentSince Mar 26, 2012 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients
Rady Childrens Hospital San Diego Past Accepting new patients
Children'S Specialists of San Diego, Inc. (CSSD) Pediatrics Past Accepting new patients

Locations

2125 Citracado Pkwy
Ste 100
Escondido, CA 92029
Phone (760) 739-1543

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

25170 Hancock Ave
Fl 1
Murrieta, CA 92562

8110 Birmingham Way
Bldg 28
San Diego, CA 92123
Phone (858) 966-4003

3020 Childrens Way
#5030
San Diego, CA 92123
Phone (858) 966-4003

3030 Childrens Way
Fl 2
San Diego, CA 92123
Phone (858) 966-5846

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

Interoperability endpoints

  • Direct secure messaging: mgarcia10193@radychildrens.direct-ci.com

Organizations & group practices 5

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": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1386805877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 CALLE FORTUNADA",
            "address_2": "SUITE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234800",
            "telephone_number": "858-309-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 BIRMINGHAM WAY",
            "address_2": "BLDG 28",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232758",
            "telephone_number": "858-966-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "MARY ABIGAIL",
        "middle_name": "SEVILLA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A89980",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "CA",
            "license": "A89980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.