Individual provider Active NPI

Ryan Emmanuel Pascua

  • Internal Medicine Physician
  • San Ysidro, CA
National Provider Identifier
1972064269
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A192121 Issued in CA
Practice address
3364 Beyer Blvd
San Ysidro, CA 92173-1322
Phone
(619) 205-4585
NPI assigned
Mar 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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 A192121 CA Primary

Addresses

Primary practice location

3364 Beyer Blvd
San Ysidro, CA 92173-1322

Mailing address

3364 Beyer Blvd
San Ysidro, CA 92173-1322
Phone (619) 205-4585

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
I20241220003464 CA Practitioner - Internal Medicine 3476995895 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A192121CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Beach Community Clinic CurrentSince Oct 5, 2024 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Sep 22, 2025 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Sep 22, 2025 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Imperial Beach Community Clinic CurrentSince Oct 5, 2024 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Past Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

949 Palm Ave
Imperial Beach, CA 91932
Phone (619) 429-3733

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

3364 Beyer Blvd
Ste 102103
San Ysidro, CA 92173
Phone (619) 205-4585

3364 Beyer Blvd
Ste 102
San Ysidro, CA 92173
Phone (702) 617-1227

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBEEDD
  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10012052
  • Direct secure messaging: rpascua60233@syhealth.direct-ci.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1972064269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3364 BEYER BLVD",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921731322",
            "telephone_number": "619-205-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3364 BEYER BLVD",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921731322",
            "telephone_number": "619-205-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCUA",
        "first_name": "RYAN",
        "middle_name": "EMMANUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A192121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ysidro, CA

Sources for this page

Verify at the official NPI Registry.