Individual provider Active NPI

Nicholas Allan Dube, IDC

  • Student in an Organized Health Care Education/Training Program
  • San Diego, CA
National Provider Identifier
1710812599
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
34800 Bob Wilson Dr Ste 200
San Diego, CA 92134-1200
Phone
(910) 627-6509
NPI assigned
Jun 15, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA Primary

Addresses

Primary practice location

34800 Bob Wilson Dr Ste 200
San Diego, CA 92134-1200

Mailing address

3375 Sterett PL
San Diego, CA 92123-2052
Phone (910) 627-6509

Other practice location 1

34101 Farenholt Ave Bldg 14
San Diego, CA 92134-7000
Phone (919) 627-6509

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1781481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1710812599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 STERETT PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232052",
            "telephone_number": "910-627-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341200",
            "telephone_number": "910-627-6509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34101 Farenholt Ave Bldg 14",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921347000",
            "country_code": "US",
            "telephone_number": "919-627-6509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBE",
        "first_name": "NICHOLAS",
        "middle_name": "ALLAN",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-15",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "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 Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.