Active NPI
Vanessa Bastidas, MD, MPH
- Family Medicine Physician
- San Ysidro, CA
National Provider Identifier
1831893478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A200390
- Practice address
- 4004 Beyer Blvd
San Ysidro, CA 92173-2007 - Phone
- (619) 662-4100
- Fax
- (619) 205-6314
- NPI assigned
- Mar 28, 2023
- Last updated
- Jul 9, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A200390 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
4004 Beyer Blvd
San Ysidro, CA 92173-2007
Mailing address
435 H Street Cv112
Chula Vista, CA 91910
Other practice location 1
435 H St
Chula Vista, CA 91910-4307
Phone (619) 691-7587
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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Arkansas College of Medicine, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1601 Precision Park LN
San Diego, CA 92173-1345
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- bvanessa19394@syhealth.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783555200000",
"number": "1831893478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "435 H STREET CV112",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "91910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4004 BEYER BLVD",
"city": "SAN YSIDRO",
"state": "CA",
"postal_code": "921732007",
"telephone_number": "619-662-4100",
"fax_number": "619-205-6314"
}
],
"practiceLocations": [
{
"address_1": "435 H St",
"address_purpose": "LOCATION",
"city": "Chula Vista",
"state": "CA",
"postal_code": "919104307",
"country_code": "US",
"telephone_number": "619-691-7587",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BASTIDAS",
"first_name": "VANESSA",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-28",
"last_updated": "2026-07-09",
"certification_date": "2026-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A200390",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Ysidro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.