NPIMap

Individual provider Active NPI

Christopher Anthony Wybourn, MD

  • Surgery Physician
  • San Diego, CA
National Provider Identifier
1629206925
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A130416 Issued in CA
Practice address
7930 Frost St
Ste 204
San Diego, CA 92123-2739
Phone
(858) 565-0104
Fax
(858) 565-0194
NPI assigned
Jun 24, 2009
Last updated
Nov 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A130416 CA Primary

Addresses

Primary practice location

7930 Frost St
Ste 204
San Diego, CA 92123-2739

Mailing address

7930 Frost St
Ste 204
San Diego, CA 92123-2739
Phone (858) 565-0104

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
I20150703000071 CA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 3274845243 Reassigns benefits to 2 organizations
Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Loyola University of Chicago, Stritch School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians

Practice addresses (Care Compare)

7901 Frost St
San Diego, CA 92123-2701
Phone (858) 939-3400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A130416CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California SFGH Medical Group CurrentSince Jun 1, 2015 Accepting new patients
Abc Trauma, Inc. CurrentSince Aug 27, 2020 Accepting new patients
Idahosurgeons Net PC CurrentSince Aug 27, 2020 Accepting new patients
University of California SFGH Medical Group Surgery CurrentSince Jun 1, 2015 Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince May 1, 2019 Accepting new patients
University of California SFGH Medical Group Surgery Current Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Coronado Hospital and Healthcare Center Past Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

4900 Hopyard Rd
Ste 100
Pleasanton, CA 94588
Phone (424) 522-8391

250 Prospect Pl
San Diego, CA 92118
Phone (619) 522-3600

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

7910 Frost St
Ste 250
San Diego, CA 92123
Phone (858) 565-0104

7930 Frost St
Ste 204
San Diego, CA 92123
Phone (858) 565-0104

1001 Potrero Ave
Bldg 5
San Francisco, CA 94110
Phone (628) 206-5753

1001 Potrero Ave
Rm 3A
San Francisco, CA 94110
Phone (415) 206-4632

Interoperability endpoints

  • Direct secure messaging: cwybourn34277@sharphealthcare.direct-ci.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1629206925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7930 FROST ST",
            "address_2": "STE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232739",
            "telephone_number": "858-565-0104",
            "fax_number": "858-565-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7930 FROST ST",
            "address_2": "STE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232739",
            "telephone_number": "858-565-0104",
            "fax_number": "858-565-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYBOURN",
        "first_name": "CHRISTOPHER",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A130416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.