Organization Active NPI

Jean-Jacques Abitbol M D a Medical Corporation

  • Specialist
  • San Diego, CA
National Provider Identifier
1487803409
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G55587 Issued in CA
Legal business name
JEAN-JACQUES ABITBOL M D A MEDICAL CORPORATION
Practice address
5395 Ruffin Rd Ste 102
San Diego, CA 92123-1338
Phone
(858) 874-2306
Fax
(858) 874-2356
NPI assigned
Sep 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Authorized official

Name
Dr. Jean-Jacques Abitbol, M.D.NPI 1245281856
Title
Ceo
Phone
(858) 874-2306

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G55587 CA Primary

Addresses

Primary practice location

5395 Ruffin Rd Ste 102
San Diego, CA 92123-1338

Mailing address

5395 Ruffin Rd Ste 102
San Diego, CA 92123-1338
Phone (858) 874-2306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090330000029 CA Part B Supplier - Clinic/Group Practice 2769549179 Receives reassigned benefits from 1 practitioner
Practice locations: Chula Vista, CA; San Diego, CA

National Provider Directory

National Provider Directory

Locations

5395 Ruffin Rd
Ste 201
San Diego, CA 92123
Phone (858) 560-0242

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1487803409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5395 RUFFIN RD STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231338",
            "telephone_number": "858-874-2306",
            "fax_number": "858-874-2356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5395 RUFFIN RD STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231338",
            "telephone_number": "858-874-2306",
            "fax_number": "858-874-2356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEAN-JACQUES ABITBOL M D A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-15",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "ABITBOL",
        "authorized_official_first_name": "JEAN-JACQUES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-874-2306",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G55587",
            "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 Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.