Individual provider Active NPI

David Charles Hall II, MD

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1467614800
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A99761 Issued in CA
Practice address
12710 Carmel Country Rd
San Diego, CA 92130-2153
Phone
(858) 499-2708
NPI assigned
Jun 26, 2008
Last updated
Sep 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A99761 CA Primary
Family Medicine Physician 207Q00000X A99761 CA
Pediatrics Physician 208000000X A99761 CA

Addresses

Primary practice location

12710 Carmel Country Rd
San Diego, CA 92130-2153

Mailing address

253 10TH Ave
Unit 1307
San Diego, CA 92101-7453

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
I20090912000062 CA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 9638225824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Virginia School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15 Grumman Rd W
Suite 1400
Bethpage, NY 11714-5029

5651 Copley Dr
Suite a
San Diego, CA 92111-7903

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
99761CAMDMarriage & Family Therapist
A99761CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Jul 20, 2009 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Family Medicine CurrentSince Jul 20, 2009 Accepting new patients
Samg Inc Past Accepting new patients

Locations

12710 Carmel Country Rd
San Diego, CA 92130
Phone (858) 499-2708

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

5651 Copley Dr
Ste A
San Diego, CA 92111
Phone (858) 262-6181

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1467614800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 10TH AVE",
            "address_2": "UNIT 1307",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12710 CARMEL COUNTRY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302153",
            "telephone_number": "858-499-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "DAVID",
        "middle_name": "CHARLES",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A99761",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A99761",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A99761",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.