Organization Active NPI

Amy Witman MD a Medical Corporation

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1982289013
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
AMY WITMAN MD A MEDICAL CORPORATION
Practice address
12395 El Camino Real Ste 115
San Diego, CA 92130-3083
Phone
(858) 724-1313
Fax
(858) 724-1314
NPI assigned
Mar 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Authorized official

Name
Dr. Amy Witman, MDNPI 1679670327
Title
President
Phone
(858) 724-1313

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

12395 El Camino Real Ste 115
San Diego, CA 92130-3083

Mailing address

12395 El Camino Real Ste 115
San Diego, CA 92130-3083
Phone (858) 724-1313

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1107031Amy Witman MD, a Medical Corporation12395 El Camino Real Suite 115, San Diego, CA 92130Certificate of waiverOct 26, 2027

National Provider Directory

National Provider Directory

Locations

12395 El Camino Real
Ste 115
San Diego, CA 92130
Phone (858) 259-9858

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1982289013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12395 EL CAMINO REAL STE 115",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303083",
            "telephone_number": "858-724-1313",
            "fax_number": "858-724-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12395 EL CAMINO REAL STE 115",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303083",
            "telephone_number": "858-724-1313",
            "fax_number": "858-724-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY WITMAN MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A",
        "authorized_official_last_name": "WITMAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-724-1313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.