Marc Franz Rivera Dedios, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

35000 Guadalcanal St
San Diego, CA 92140-5599

Phone

(619) 524-4045

NPI assigned

Nov 7, 2022

Last updated

Jun 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Branch Medical Clinic MCRD

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • San Diego, CA
  • NPI 1649446857
  NPD (past)
• United States Navy

  • Military Hospital
  • San Diego, CA
  • NPI 1003226309
  NPD (past)

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1932817194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ATTN: MEDICAL STAFF SERVICES",
            "address_2": "34800 BOB WILSON DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35000 GUADALCANAL ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921405599",
            "telephone_number": "619-524-4045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34101 Farenholt Ave Bldg 14",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921347000",
            "country_code": "US",
            "telephone_number": "619-432-7968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "34800 Bob Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921347000",
            "country_code": "US",
            "telephone_number": "619-532-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEDIOS",
        "first_name": "MARC FRANZ",
        "middle_name": "RIVERA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-07",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Computed Tomography",
            "state": "CA",
            "license": "535689",
            "primary": false
        },
        {
            "code": "2471C3402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Radiography",
            "state": "CA",
            "license": "535689",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Bennitt Deconde, M.D.
• Taylor Decool, NP
• Joseph Barrett Decunzo III
• Dedicated Healthcare LLC
• Enrique Escapolar Dedios Jr.
• Natalia Dedios
• Julie Dedman
• Brittney Taylor Dee, MOT, OTR/L
• Richard Dee
• Donald Christopher Deede

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.