Individual provider Active NPI

David Benjamin Tevis La Vine, M.D.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1962635763
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A113694 Issued in CA
Practice address
11375 El Camino Real Ste 250
San Diego, CA 92130-2994
Phone
(858) 214-3150
Fax
(858) 214-3153
NPI assigned
Aug 26, 2009
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A113694 CA Primary

Addresses

Primary practice location

11375 El Camino Real Ste 250
San Diego, CA 92130-2994

Mailing address

11375 El Camino Real Ste 250
San Diego, CA 92130-2994
Phone (858) 214-3150

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111122000747 CA Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Geriatric Medicine 7012181365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Georgia School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A113694CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Internal Medicine CurrentSince Jul 29, 2013 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Jul 29, 2013 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Internal Medicine Current Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

3811 Valley Centre Dr
San Diego, CA 92130
Phone (858) 554-8645

9730 Summers Ridge Rd
#100
San Diego, CA 92121
Phone (858) 549-7400

Interoperability endpoints

  • Direct secure messaging: dlavine19494@scrippshlth.medalliesdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1962635763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11375 EL CAMINO REAL STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302994",
            "telephone_number": "858-214-3150",
            "fax_number": "858-214-3153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11375 EL CAMINO REAL STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302994",
            "telephone_number": "858-214-3150",
            "fax_number": "858-214-3153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA VINE",
        "first_name": "DAVID",
        "middle_name": "BENJAMIN TEVIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-26",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A113694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.