NPIMap

Individual provider Active NPI

Rahil Abdemannan Bandukwala, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Encinitas, CA
National Provider Identifier
1518036888
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
20A 7863 Issued in CA
Practice address
317 N El Camino Real
Suite 201
Encinitas, CA 92024-2811
Phone
(760) 634-0064
Fax
(760) 334-2006
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 20A 7863 CA Primary

Addresses

Primary practice location

317 N El Camino Real
Suite 201
Encinitas, CA 92024-2811

Mailing address

10625 Montego Dr
San Diego, CA 92124-1908
Phone (858) 829-2385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040722001382 CA Practitioner - EndocrinologyPractitioner - Internal Medicine 1759361470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scke IncGroup PAC ID 6608822895, 20 clinicians

Practice addresses (Care Compare)

23141 Moulton Pkwy
Suite 102
Laguna Hills, CA 92653-1241
Phone (949) 916-9100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A 7863CAMDEndocrinology, Diabetes & Metabolism Physician
7863CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Scke, Inc Endocrinology, Diabetes & Metabolism CurrentSince Jan 1, 2011 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Sharp Chula Vista Medical Center Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
United Medical Doctors Past Accepting new patients

Locations

22 Odyssey
Ste 115
Irvine, CA 92618
Phone (949) 988-7550

23141 Moulton Pkwy
Ste 102
Laguna Hills, CA 92653
Phone (949) 916-9100

23331 El Toro Rd
Ste 102
Lake Forest, CA 92630
Phone (949) 633-8189

655 Camino de los Mares
#12
San Clemente, CA 92673
Phone (949) 916-9100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JCEAAA

Organizations & group practices 7

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 3

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518036888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10625 MONTEGO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921241908",
            "telephone_number": "858-829-2385",
            "fax_number": "858-576-0954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 N EL CAMINO REAL",
            "address_2": "SUITE 201",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242811",
            "telephone_number": "760-634-0064",
            "fax_number": "760-334-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDUKWALA",
        "first_name": "RAHIL",
        "middle_name": "ABDEMANNAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "20A 7863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.