Natalia E Fudim, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A55382 Issued in CA

Practice address

4147 Adams Ave
San Diego, CA 92116-2509

Phone

(619) 281-1932

Fax

(619) 281-1947

NPI assigned

Sep 29, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 6, 2015 through Oct 6, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Eric B Raimo M D a Professional Medical Corporation

  • Psychiatry Physician
  • San Diego, CA
  • NPI 1255845962
  NPD (past)
• Hawthorne Psychiatric Associates, SC

  • Psychiatry Physician
  • Vernon Hills, IL
  • NPI 1982717674
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254787200000",
    "number": "1891887279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4147 ADAMS AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921162509",
            "telephone_number": "619-281-1932",
            "fax_number": "619-281-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4147 ADAMS AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921162509",
            "telephone_number": "619-281-1932",
            "fax_number": "619-281-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUDIM",
        "first_name": "NATALIA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2009-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A55382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Joseph Fuchs
• Samme Fuchs
• Mark Tristan Fucinari, CNIM
• Mary Jeanne Fudge, RDN
• Nicole Fudge, CSFA
• Ana Lucia Fuentes Baldarrago, MD
• Heriberto Fuentes Cervantes
• Mariana Fuentes Vasquez
• Amanda Fuentes
• Andrea Paola Fuentes, MD

• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.