Active NPI
Adam D Breslow, MD
- Pediatrics Physician
- Cula Vista, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G60853
- 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, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G60853 | Other | CA | MD 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G60853 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| UC San Diego Health Community Group | Current | 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
- 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.
-
- Community Health Clinic/Center
- San Diego, CA
- NPI 1659864247
-
- Pediatrics Physician
- San Diego, CA
- NPI 1184788291
-
- Children's Hospital
- San Diego, CA
- NPI 1336359389
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Diego, CA
- NPI 1851303994
-
dba UCSD Pediatric and Adolescent Associates
- Pediatric Adolescent Medicine Physician
- San Diego, CA
- NPI 1013035716
Pediatrics
-
- Clinical Medical Laboratory
- La Jolla, CA
- NPI 1427034990
-
dba Birch Patrick Convalescent Center
- Skilled Nursing Facility
- Chula Vista, CA
- NPI 1538142369
-
- Pediatric Adolescent Medicine Physician
- San Diego, CA
- NPI 1427259597
Pediatrics
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.