Individual provider Active NPI

Daniel Dewerd, MD

  • Otolaryngology Physician
  • San Diego, CA
National Provider Identifier
1447663794
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
CFE28735 Issued in CA
Practice address
3627 Riviera Dr
San Diego, CA 92109-6641
Phone
(858) 270-0239
Fax
(858) 270-0239
NPI assigned
Jun 4, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X CFE28735 CA Primary

Addresses

Primary practice location

3627 Riviera Dr
San Diego, CA 92109-6641

Mailing address

3627 Riviera Dr
San Diego, CA 92109-6641
Phone (858) 270-0239

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

LicenseStateTypeSpecialty
CFE28735CAMDOtolaryngology Physician

NPI Registry JSON

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1447663794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 RIVIERA DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921096641",
            "telephone_number": "858-270-0239",
            "fax_number": "858-270-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 RIVIERA DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921096641",
            "telephone_number": "858-270-0239",
            "fax_number": "858-270-0239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWERD",
        "first_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "CFE28735",
            "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 Jun 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.