Active NPI
Katherine Mary Ozanich, M.D.
- Dermatology Physician
- San Diego, CA
National Provider Identifier
1598778516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- G47006
- Practice address
- 16950 Via Tazon
San Diego, CA 92127-1607 - Phone
- (858) 521-2393
- NPI assigned
- Aug 14, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | G47006 | CA | Primary |
Addresses
Primary practice location
16950 Via Tazon
San Diego, CA 92127-1607
Mailing address
16950 Via Tazon
San Diego, CA 92127-1607
Phone (858) 521-2393
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G470060 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47006 | CA | MD | Dentist |
| G47006 | CA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351814400000",
"number": "1598778516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16950 VIA TAZON",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921271607",
"telephone_number": "858-521-2393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16950 VIA TAZON",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921271607",
"telephone_number": "858-521-2393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OZANICH",
"first_name": "KATHERINE",
"middle_name": "MARY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2012-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G47006",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G470060",
"state": "CA"
}
],
"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 Nov 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.