Scott Gillin MD Inc

Primary specialty

Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X

Legal business name

SCOTT GILLIN MD INC

Doing business as

Seaside Ketamine

Practice address

1953 San Elijo Ave Ste 200
Cardiff, CA 92007-2348

Phone

(858) 215-2618

NPI assigned

Aug 9, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Scott Gillin, MDNPI 1164456513

Title

Owner

Phone

(858) 254-0512

Specialties & licenses 5

Addresses

Other names 1

• Seaside Ketamine Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott A. Gillin, MD

  • Pediatric Anesthesiology Physician
  • Cardiff-by-the-Sea, CA
  • NPI 1164456513
  Medicare reassignment NPD Authorized official
• Brooke Climer, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Oceanside, CA
  • NPI 1992583421
  Medicare reassignment NPD
• Diana L. Pasquarello, PA-C

  • Physician Assistant
  • Escondido, CA
  • NPI 1417037912
  Medicare reassignment NPD

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

{
    "created_epoch": "1754697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1770468548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13990 MERCADO DR",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920143124",
            "telephone_number": "858-254-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1953 SAN ELIJO AVE STE 200",
            "city": "CARDIFF",
            "state": "CA",
            "postal_code": "920072348",
            "telephone_number": "858-215-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT GILLIN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-09",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "GILLIN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-254-0512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seaside Ketamine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Allison Robins, DPT
• Tammy Lynn Rogers, LCSW
• Ron Richard Romero, D.C.
• Charmaine Michette Ross
• Sally Scheurman
• Elizabeth Sergeant
• Cathryn Sharer, LMFT
• David Shores, D.C.
• Jill Ellen Siegelman, MFT
• SMHS LLC

• Pediatric Anesthesiology Physician in Cardiff, CA
• Providers in Cardiff, CA by specialty
• Pediatric Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.