Active NPI
Jae Elkind
- Molecular Genetic Pathology (Pathology) Physician
- San Diego, CA
National Provider Identifier
1922497700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Molecular Genetic Pathology (Pathology) Physician
- License
- A152642
- Practice address
- 200 W Arbor Dr
San Diego, CA 92103-9000 - Phone
- (619) 543-8254
- NPI assigned
- Jan 15, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Molecular Genetic Pathology (Pathology) Physician | 207ZP0007X | A152642 | CA | Primary |
Addresses
Primary practice location
200 W Arbor Dr
San Diego, CA 92103-9000
Mailing address
PO Box 232410
San Diego, CA 92193-2410
Phone (800) 926-8273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A152642 | CA | MD | Molecular Genetic Pathology (Pathology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630454400000",
"number": "1922497700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 232410",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921932410",
"telephone_number": "800-926-8273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W ARBOR DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921039000",
"telephone_number": "619-543-8254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELKIND",
"first_name": "JAE",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-15",
"last_updated": "2021-09-01",
"certification_date": "2021-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207ZP0007X",
"taxonomy_group": "",
"desc": "Pathology, Molecular Genetic Pathology",
"state": "CA",
"license": "A152642",
"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 Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.