NPIMap

Organization Active NPI

San Diego Critical Care Medical Group, Inc

  • Internal Medicine Physician
  • El Cajon, CA
National Provider Identifier
1609915990
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SAN DIEGO CRITICAL CARE MEDICAL GROUP, INC
Practice address
2732 Navajo Rd Ste 202a
El Cajon, CA 92020-2149
Phone
(619) 461-1920
Fax
(619) 461-1919
NPI assigned
Feb 5, 2007
Last updated
Nov 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Authorized official

Name
Dr. Barzan MohedinNPI 1639235096
Title
President
Phone
(760) 798-0346

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
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

2732 Navajo Rd Ste 202a
El Cajon, CA 92020-2149

Mailing address

PO Box 2249
La Mesa, CA 91943-2249
Phone (619) 461-1920

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090108000551 CA Part B Supplier - Clinic/Group Practice 7911083886 Receives reassigned benefits from 84 practitioners
Practice locations: Chula Vista, CA; Coronado, CA; La Mesa, CA

National Provider Directory

National Provider Directory

Locations

8851 Center Dr
Ste 305
La Mesa, CA 91942
Phone (619) 442-0234

Practitioners & affiliated clinicians

Practitioners 96

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 96

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1609915990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2249",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919432249",
            "telephone_number": "619-461-1920",
            "fax_number": "619-461-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2732 NAVAJO RD STE 202A",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920202149",
            "telephone_number": "619-461-1920",
            "fax_number": "619-461-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO CRITICAL CARE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "MOHEDIN",
        "authorized_official_first_name": "BARZAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-798-0346",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.