Individual provider Active NPI

Adam D Breslow, MD

  • Pediatrics Physician
  • Cula Vista, CA
National Provider Identifier
1972574085
Registry record updated Jan 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G60853 Issued in CA
Practice address
765 Medical Center CT
#210
Cula Vista, CA 91911
Phone
(619) 482-3090
Fax
(619) 482-7350
NPI assigned
Jan 27, 2006
Last updated
Jan 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G60853 CA Primary

Addresses

Primary practice location

765 Medical Center CT
#210
Cula Vista, CA 91911

Mailing address

3860 Calle Fortunada
Suite 200
San Diego, CA 92123
Phone (858) 636-4300

Other identifiers 1

IdentifierTypeStateIssuer
G60853OtherCAMD LICENSE

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
I20220912000888 CA Practitioner - Pediatric Medicine 4082099064 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G60853CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC San Diego Health Community Group CurrentSince Jun 1, 2022 Accepting new patients
Regents of the University of California Pediatrics Past Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients
Scripps Health Past Accepting new patients
Ucsd Pediatric Associates Pediatrics Past Accepting new patients
Sharp Chula Vista Medical Center Past Accepting new patients
Scripps Health Past Accepting new patients
Rady Children's Hospital San Diego Past Accepting new patients

Locations

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Interoperability endpoints

  • Direct secure messaging: abreslow9157@radychildrens.direct-ci.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296172800000",
    "number": "1972574085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 CALLE FORTUNADA",
            "address_2": "SUITE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92123",
            "telephone_number": "858-636-4300",
            "fax_number": "858-636-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 MEDICAL CENTER CT",
            "address_2": "#210",
            "city": "CULA VISTA",
            "state": "CA",
            "postal_code": "91911",
            "telephone_number": "619-482-3090",
            "fax_number": "619-482-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESLOW",
        "first_name": "ADAM",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2011-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G60853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "G60853",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.