Organization Active NPI

My Primary Care

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1629869573
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MY PRIMARY CARE
Practice address
3111 Camino del Rio N Ste 452
San Diego, CA 92108-5720
Phone
(760) 662-8659
NPI assigned
May 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Authorized official

Name
Adam K Pasilas
Title
Chief Operations Officer
Phone
(760) 662-8659

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3111 Camino del Rio N Ste 452
San Diego, CA 92108-5720

Mailing address

1741 Eastlake Pkwy Ste 102-305
Chula Vista, CA 91915-2032
Phone (760) 662-8659

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251104001220 CA Part B Supplier - Clinic/Group Practice 0547750044 Receives reassigned benefits from 1 practitioner
Practice locations: Chula Vista, CA

National Provider Directory

National Provider Directory

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": "1747008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1629869573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 EASTLAKE PKWY STE 102-305",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919152032",
            "telephone_number": "760-662-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 CAMINO DEL RIO N STE 452",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085720",
            "telephone_number": "760-662-8659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "PASILAS",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "760-662-8659"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 21, 2025; 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.