Individual provider Active NPI

Maria Regina Abesa Delozier, M.D.

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1497071443
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A124305 Issued in CA
Practice address
6911 Convoy CT Dept of
San Diego, CA 92111-1014
Phone
(619) 528-5000
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A124305 CA Primary

Addresses

Primary practice location

6911 Convoy CT Dept of
San Diego, CA 92111-1014

Mailing address

393 E Walnut St
Pasadena, CA 91188-0001
Phone (619) 464-6434

Other practice location 1

4725 Market St
San Diego, CA 92102-4715
Phone (619) 515-2560

Other names 1

  • Maria Regina Arayata Abesa Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20140121000283 CA Practitioner - Pediatric Medicine 0042448094 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Southern California Permanente Medical Group CurrentSince May 21, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 12, 2020 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Mar 24, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Mar 24, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
My Catholic Doctor, P.L.L.C. Pediatrics Past Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

8080 Parkway Dr
La Mesa, CA 91942
Phone (619) 589-3456

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

393 E Walnut St
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

6911 Convoy Ct
San Diego, CA 92111
Phone (619) 644-6500

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

4725 Market St
San Diego, CA 92102
Phone (619) 515-2560

Organizations & group practices 9

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": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1497071443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E WALNUT ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911880001",
            "telephone_number": "619-464-6434",
            "fax_number": "619-464-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 CONVOY CT DEPT OF",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111014",
            "telephone_number": "619-528-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4725 Market St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921024715",
            "country_code": "US",
            "telephone_number": "619-515-2560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELOZIER",
        "first_name": "MARIA REGINA",
        "middle_name": "ABESA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A124305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARIA REGINA",
            "last_name": "ABESA",
            "middle_name": "ARAYATA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.