Active NPI
Pedi Mirdamadi
- Naturopath
- La Jolla, CA
National Provider Identifier
1467095539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- ND1106
- Practice address
- 6919 La Jolla Blvd
La Jolla, CA 92037-5427 - Phone
- (858) 459-6919
- NPI assigned
- Oct 22, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | ND1106 | CA | Primary |
Addresses
Primary practice location
6919 La Jolla Blvd
La Jolla, CA 92037-5427
Mailing address
11228 Vista Sorrento Pkwy Unit I300
San Diego, CA 92130-7622
Phone (858) 253-1222
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND1106 | CA | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571702400000",
"number": "1467095539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11228 VISTA SORRENTO PKWY UNIT I300",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921307622",
"telephone_number": "858-253-1222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6919 LA JOLLA BLVD",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920375427",
"telephone_number": "858-459-6919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRDAMADI",
"first_name": "PEDI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-22",
"last_updated": "2019-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "CA",
"license": "ND1106",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.