Individual provider Active NPI

Ashkan Vafadaran, M.D.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1659634517
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A137394 Issued in CA
Practice address
1250 6TH Ave
Suite 100; Family Health Centers of San Diego
San Diego, CA 92101-4300
Phone
(619) 515-2430
NPI assigned
Jun 15, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A137394 CA Primary

Addresses

Primary practice location

1250 6TH Ave
Suite 100; Family Health Centers of San Diego
San Diego, CA 92101-4300

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160909002578 CA Practitioner - Internal Medicine 6002102449 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A137394CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego Inc CurrentSince Aug 3, 2016 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Aug 3, 2016 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients

Locations

1250 6th Ave
Ste 100
San Diego, CA 92101
Phone (619) 515-2430

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1659634517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 6TH AVE",
            "address_2": "SUITE 100; FAMILY HEALTH CENTERS OF SAN DIEGO",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014300",
            "telephone_number": "619-515-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAFADARAN",
        "first_name": "ASHKAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A137394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.