Active NPI
Marialyn Jo Sardo, M.D.
- Plastic and Reconstructive Surgery Physician
- La Jolla, CA
National Provider Identifier
1679724462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- G51066
- Practice address
- 9850 Genesee Avenue
Ste. 380
La Jolla, CA 92037 - Phone
- (858) 452-6226
- Fax
- (858) 452-6235
- NPI assigned
- Oct 10, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | G51066 | CA | Primary |
Addresses
Primary practice location
9850 Genesee Avenue
Ste. 380
La Jolla, CA 92037
Mailing address
9850 Genesee Ave.
Ste 410
La Jolla, CA 92037
Phone (858) 452-6226
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WG510660 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scripps Health | Current | Accepting new patients |
Interoperability endpoints
- msardo37010@scrippshlth.medalliesdirect.net
Organizations & group practices 2
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.
-
- Plastic Surgery Physician
- La Jolla, CA
- NPI 1679844880
-
dba Scripps Hospital Medical Services
- General Acute Care Hospital
- San Diego, CA
- NPI 1487928891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316044800000",
"number": "1679724462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9850 GENESEE AVE.",
"address_2": "STE 410",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "92037",
"telephone_number": "858-452-6226",
"fax_number": "858-452-6235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9850 GENESEE AVENUE",
"address_2": "STE. 380",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "92037",
"telephone_number": "858-452-6226",
"fax_number": "858-452-6235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SARDO",
"first_name": "MARIALYN",
"middle_name": "JO",
"name_prefix": "Ms.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-10",
"last_updated": "2011-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "CA",
"license": "G51066",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "WG510660",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.