Bobak Thomas Pousti

Key facts

NPI

1932736451

Entity type

Individual (NPI type 1)

Primary specialty

Dermatology Physician 207N00000X

License

1932736451 (CA)

Practice address

655 Euclid Ave Ste 304
National City, CA 91950-2974

Phone

(619) 267-8303

Fax

(619) 267-4835

NPI assigned

Mar 25, 2020

Sex

Male

Sole proprietor

No

Organizations & group practices 3

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.

• William F Resh MD, Skin & Skin Cancer Medical Group of San Diego, Inc. Specialist · National City, CA · NPI 1790973162
  Medicare reassignment Care Compare group NPD CA · DERMATOLOGY
• Scripps Health General Acute Care Hospital · San Diego, CA · NPI 1487928891
  NPD
• William F Resh M.D. Skin & Skin Cancer Medical Group of San Diego, Inc Dermatology Physician · San Diego, CA · NPI 1831938232
  NPD DERMATOLOGY

Medicare Care Compare profile

Specialty

Dermatology

Education

Temple University School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

William F Resh MD Skin and Skin Cancer Medical Group of San Diego Inc (18 clinicians)

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles (3 of 4)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: bpousti375844@scrippshlth.medalliesdirect.net

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 11, 2024.

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1932736451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8899 UNIVERSITY CENTER LN STE 350",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221010",
            "telephone_number": "858-657-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 EUCLID AVE STE 304",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502974",
            "telephone_number": "619-267-8303",
            "fax_number": "619-267-4835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15725 Pomerado Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Poway",
            "state": "CA",
            "postal_code": "920642057",
            "country_code": "US",
            "telephone_number": "619-267-8303",
            "fax_number": "619-267-4835",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 W Madison Ave",
            "address_purpose": "LOCATION",
            "city": "El Cajon",
            "state": "CA",
            "postal_code": "920203406",
            "country_code": "US",
            "telephone_number": "619-579-5115",
            "fax_number": "619-749-6174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5222 Balboa Ave # Floors56",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921176904",
            "country_code": "US",
            "telephone_number": "619-267-8303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POUSTI",
        "first_name": "BOBAK",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "1932736451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in National City, CA · Dermatology Physician in California