Individual provider Active NPI

Mariam Bonyadi Camacho, MD, PHD

  • Internal Medicine Physician
  • La Jolla, CA
National Provider Identifier
1457937898
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A185860 Issued in CA
Practice address
8950 Villa la Jolla Dr Ste C129
La Jolla, CA 92037-1707
Phone
(858) 450-5900
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A185860 CA Primary

Addresses

Primary practice location

8950 Villa la Jolla Dr Ste C129
La Jolla, CA 92037-1707

Mailing address

8950 Villa la Jolla Dr Ste C129
La Jolla, CA 92037-1707
Phone (858) 450-5900

Other practice location 1

4094 4th Ave
San Diego, CA 92103-2143
Phone (619) 515-2545

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
I20240805003897 CA Practitioner - Internal Medicine 9537606777 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Daniel Michaels M D IncGroup PAC ID 4082899984, 5 clinicians

Practice addresses (Care Compare)

8950 Villa la Jolla Dr
Suite C129
La Jolla, CA 92037-1707
Phone (858) 450-5900

Hospital & facility affiliations

  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324
  • Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A185860CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Michaels M D Inc CurrentSince Jul 30, 2024 Accepting new patients

Locations

8950 Villa La Jolla Dr
Ste C129
La Jolla, CA 92037
Phone (858) 450-5900

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1457937898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 VILLA LA JOLLA DR STE C129",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371707",
            "telephone_number": "858-450-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 VILLA LA JOLLA DR STE C129",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371707",
            "telephone_number": "858-450-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4094 4th Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032143",
            "country_code": "US",
            "telephone_number": "619-515-2545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "MARIAM",
        "middle_name": "BONYADI",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A185860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.