Organization Active NPI

RJ Fernandez MD Inc Apc.

  • Internal Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1609963156
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
207R00000X Issued in CA
Legal business name
RJ FERNANDEZ MD INC APC.
Practice address
450 4TH Ave Ste 201
Chula Vista, CA 91910-4428
Phone
(619) 476-9054
Fax
(619) 476-9056
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Authorized official

Name
Mr. Rodrigo Jose Fernandez. M.D., M.D.
Title
Owner / MD
Phone
(619) 476-9054

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 207R00000X CA Primary

Addresses

Primary practice location

450 4TH Ave Ste 201
Chula Vista, CA 91910-4428

Mailing address

450 4TH Ave Ste 201
Chula Vista, CA 91910-4428
Phone (619) 476-9054

Other identifiers 2

IdentifierTypeStateIssuer
00A444410MedicaidCA
1366539793OtherCANPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040519001585 CA Part B Supplier - Clinic/Group Practice 6800887795 Receives reassigned benefits from 1 practitioner
Practice locations: Chula Vista, CA

National Provider Directory

National Provider Directory

Locations

450 Fourth Ave
Ste 201
Chula Vista, CA 91910
Phone (619) 476-9054

Practitioners & affiliated clinicians

Practitioners 2

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": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627948800000",
    "number": "1609963156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 4TH AVE STE 201",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104428",
            "telephone_number": "619-476-9054",
            "fax_number": "619-476-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 4TH AVE STE 201",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104428",
            "telephone_number": "619-476-9054",
            "fax_number": "619-476-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RJ FERNANDEZ MD INC APC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ. M.D.",
        "authorized_official_first_name": "RODRIGO",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "OWNER / MD",
        "authorized_official_telephone_number": "619-476-9054",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "207R00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A444410",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1366539793",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.