Edward Kavalerchik, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A87968 Issued in CA

Practice address

3350 La Jolla Village Dr, 111-E
VA SD la Jolla Medical Ctr
San Diego, CA 92161-0002

Phone

(858) 642-3356

NPI assigned

Oct 15, 2006

Last updated

Oct 13, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Scripps Clinic Medical Group, Inc

  dba Scripps Proton Therapy Center

  • Radiation Oncology Physician
  • San Diego, CA
  • NPI 1073853180
  NPD (past)
• Scripps Clinic Medical Group, Inc

  dba Scripps Clinic

  • Internal Medicine Physician
  • La Jolla, CA
  • NPI 1538297726
  NPD (past)

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1730279035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR, 111-E",
            "address_2": "VA SD LA JOLLA MEDICAL CTR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-642-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR, 111-E",
            "address_2": "VA SD LA JOLLA MEDICAL CTR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-642-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVALERCHIK",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-15",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A87968",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CA",
            "license": "A87968",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A87968",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730279035",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandeep Kaur
• Philip Indrajit Kaushall, PHD
• Kenneth Kaushansky, M.D
• Renu Vishwanath Kaushik, MD
• Michelle Kautz, DO
• Kevin Kavanagh, PHARMD
• Nicholas Demetrios Kavathas
• Kameron Kaveh
• Kavod Charter School
• Sophia Kavoulakos

• Internal Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.

Verify at the official NPI Registry.