Individual provider Active NPI

Damaris Garcia Sandoval, MD

  • Family Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1447838883
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A183412 Issued in CA
Practice address
435 H St
Chula Vista, CA 91910-4307
Phone
(619) 691-7587
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Family Medicine Physician 207Q00000X A183412 CA Primary

Addresses

Primary practice location

435 H St
Chula Vista, CA 91910-4307

Mailing address

435 H St
Chula Vista, CA 91910-4307

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
I20230815002917 CA Practitioner - Family Practice 2567824022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 428-4463

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A183412CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Jun 12, 2023 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Jun 12, 2023 Accepting new patients

Locations

435 H St
Chula Vista, CA 91910
Phone (619) 691-7000

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

4004 Beyer Blvd
San Ysidro, CA 92173
Phone (619) 428-1330

1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: sdamarisgarcia19361@syhealth.direct-ci.com

Organizations & group practices 3

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1447838883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 H ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 H ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104307",
            "telephone_number": "619-691-7587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA SANDOVAL",
        "first_name": "DAMARIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A183412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.