Individual provider Active NPI

Dylan Quinn Jawahir, L.AC., L.M.T.

  • Acupuncturist
  • San Diego, CA
National Provider Identifier
1750691721
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
13828 Issued in CA
Practice address
11848 Bernardo Plaza CT
Suite 100
San Diego, CA 92128-2416
Phone
(858) 349-5057
NPI assigned
Oct 8, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 13828 CA Primary
Massage Therapist 225700000X

Addresses

Primary practice location

11848 Bernardo Plaza CT
Suite 100
San Diego, CA 92128-2416

Mailing address

10910 Polaris Dr
San Diego, CA 92126-2446
Phone (858) 349-5057

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": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286496000000",
    "number": "1750691721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10910 POLARIS DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262446",
            "telephone_number": "858-349-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11848 BERNARDO PLAZA CT",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282416",
            "telephone_number": "858-349-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAWAHIR",
        "first_name": "DYLAN",
        "middle_name": "QUINN",
        "name_prefix": "Mr.",
        "credential": "L.AC., L.M.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-08",
        "last_updated": "2010-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "13828",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Oct 8, 2010; 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.