Active NPI
Mark Anthony Knight, M.D.
- Child & Adolescent Psychiatry Physician
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- A94460
- Practice address
- 2204 National Ave
San Diego, CA 92113-3615 - Phone
- (619) 906-4648
- NPI assigned
- Dec 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | A94460 | CA | Primary |
Addresses
Primary practice location
2204 National Ave
San Diego, CA 92113-3615
Mailing address
823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A94460 | CA | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Ehab Yacoub MD Inc. | Child & Adolescent Psychiatry | Current | Accepting new patients |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Family Health Centers of San Diego Inc | Current | Accepting new patients |
Locations
1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113
17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929
1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500
823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323
3544 30th St
San Diego, CA 92104
Phone (619) 515-2424
2204 National Ave
San Diego, CA 92113
Phone (619) 515-2355
Organizations & group practices 4
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.
-
- Child & Adolescent Psychiatry Physician
- Gardena, CA
- NPI 1417373713
-
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1447281936
-
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1235521782
-
- Federally Qualified Health Center (FQHC)
- Escondido, CA
- NPI 1356178180
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692835200000",
"number": "1851573554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "823 GATEWAY CENTER WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921024541",
"telephone_number": "619-515-2300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2204 NATIONAL AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921133615",
"telephone_number": "619-906-4648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNIGHT",
"first_name": "MARK",
"middle_name": "ANTHONY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-04",
"last_updated": "2023-08-24",
"certification_date": "2023-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "A94460",
"primary": true
}
],
"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 Aug 24, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.