Individual provider Active NPI

Mark A. Kalish, M.D.

  • Specialist
  • San Diego, CA
National Provider Identifier
1710911490
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G38634 Issued in CA
Practice address
3131 Camino del Rio N
Suite 270
San Diego, CA 92108-5701
Phone
(619) 282-7172
Fax
(619) 282-7626
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G38634 CA Primary

Addresses

Primary practice location

3131 Camino del Rio N
Suite 270
San Diego, CA 92108-5701

Mailing address

3131 Camino del Rio N
Suite 270
San Diego, CA 92108-5701
Phone (619) 282-7172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38634CAMDPeriodontist
G38634CAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710911490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 CAMINO DEL RIO N",
            "address_2": "SUITE 270",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085701",
            "telephone_number": "619-282-7172",
            "fax_number": "619-282-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 CAMINO DEL RIO N",
            "address_2": "SUITE 270",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085701",
            "telephone_number": "619-282-7172",
            "fax_number": "619-282-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALISH",
        "first_name": "MARK",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G38634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.