NPIMap

Organization Active NPI

San Diego Orthopaedic Associates Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • San Diego, CA
National Provider Identifier
1407817448
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SAN DIEGO ORTHOPAEDIC ASSOCIATES MEDICAL GROUP, INC.
Practice address
4060 4TH Ave Ste 700
San Diego, CA 92103-2121
Phone
(619) 299-8500
Fax
(619) 297-1443
NPI assigned
Mar 29, 2006
Last updated
Apr 24, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CALIFORNIA ORTHOPAEDIC INSTITUTE MEDICAL ASSOCIATES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Authorized official

Name
Anabel Mendoza
Title
Supervisor
Phone
(619) 501-2200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

4060 4TH Ave Ste 700
San Diego, CA 92103-2121

Mailing address

4060 Fourth Ave Ste 700
San Diego, CA 92103-2121
Phone (619) 299-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050108000198 CA Part B Supplier - Clinic/Group Practice 4385692102 Receives reassigned benefits from 13 practitioners
Practice locations: San Diego, CA
O20100930052582 CA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 4385692102 Practice locations: San Diego, 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
05D2066450San Diego Orthopaedic Associates4060 4TH Ave 7TH FL, San Diego, CA 92103Certificate of waiverSep 25, 2027

National Provider Directory

National Provider Directory
Part of
California Orthopedic I

Locations

1665 S Imperial Ave
El Centro, CA 92243
Phone (760) 352-7216

4060 4th Ave
Fl 7
San Diego, CA 92103
Phone (619) 686-8313

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776988800000",
    "number": "1407817448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 FOURTH AVE STE 700",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032121",
            "telephone_number": "619-299-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 4TH AVE STE 700",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032121",
            "telephone_number": "619-299-8500",
            "fax_number": "619-297-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO ORTHOPAEDIC ASSOCIATES MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALIFORNIA ORTHOPAEDIC INSTITUTE MEDICAL ASSOCIATES INC",
        "enumeration_date": "2006-03-29",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "ANABEL",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "619-501-2200"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "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 Apr 24, 2026; 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.