Individual provider Active NPI

Nana Matoba, M.D.

  • Neonatal-Perinatal Medicine Physician
  • San Diego, CA
National Provider Identifier
1801952197
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
C183845 Issued in CA
Practice address
3010 Childrens Way
San Diego, CA 92123-4223
Phone
(858) 966-5818
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X C183845 CA Primary

Addresses

Primary practice location

3010 Childrens Way
San Diego, CA 92123-4223

Mailing address

3020 Childrens Way # Mc5003
San Diego, CA 92123-4223
Phone (858) 309-6300

Other practice location 1

9300 Campus Point Dr
LA Jolla, CA 92037-1300
Phone (858) 249-1703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240305001633 CA Practitioner - Pediatric Medicine 2769542596 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C183845CAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jan 22, 2024 Accepting new patients
Regents of the University of California Neonatal-Perinatal Medicine CurrentSince Jan 22, 2024 Accepting new patients
Regents of the University of California Past Accepting new patients
Ann & Robert H Lurie Childrens Hospital of Chicago Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation PastSince Jan 15, 2023 Accepting new patients
Rady Children'S Hospital San Diego PastSince Jan 15, 2023 Accepting new patients

Locations

435 H St
Chula Vista, CA 91910
Phone (619) 691-7000

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

9300 Campus Point Dr
Fl 8
La Jolla, CA 92037

File 57326
Los Angeles, CA 90074

3665 Kearny Villa Rd
Ste 400
San Diego, CA 92123
Phone (858) 966-5817

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

3750 Convoy St
Ste 312
San Diego, CA 92111
Phone (858) 292-7200

3750 Convoy St
Ste 110
San Diego, CA 92111

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1801952197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-5818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9300 Campus Point Dr",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920371300",
            "country_code": "US",
            "telephone_number": "858-249-1703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATOBA",
        "first_name": "NANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "C183845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.