NPIMap

Organization Active NPI

Myezmed

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1982441341
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MYEZMED
Practice address
6458 Fischer Way
San Diego, CA 92130-5804
Phone
(619) 823-1947
NPI assigned
Jul 12, 2024
Last updated
Jul 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Authorized official

Name
Dr. Guillermo Castillo, MD
Title
Ceo
Phone
(619) 823-1947

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

6458 Fischer Way
San Diego, CA 92130-5804

Mailing address

553 N Pacific Coast Hwy Ste B-105
Redondo Beach, CA 90277-2163
Phone (310) 850-6279

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR, FL, TX, AR5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20250506002558 CA Part B Supplier - Clinic/Group Practice 3072030758 Receives reassigned benefits from 8 practitioners
Practice locations: San Diego, CA; Orange, CA; Beaumont, CA
O20260508001064 OR Part B Supplier - Clinic/Group Practice 3072030758 Practice locations: Portland, OR
O20260522003366 FL Part B Supplier - Clinic/Group Practice 3072030758 Receives reassigned benefits from 1 practitioner
Practice locations: West Palm Beach, FL; Riverview, FL; Fernandina, FL; Middleburg, FL
O20260625002981 TX Part B Supplier - Clinic/Group Practice 3072030758 Receives reassigned benefits from 1 practitioner
Practice locations: Austin, TX; Dallas, TX; San Antonio, TX
O20260626004323 AR Part B Supplier - Clinic/Group Practice 3072030758 Receives reassigned benefits from 1 practitioner
Practice locations: Stamps, AR

National Provider Directory

National Provider Directory

Locations

305 Main St
Stamps, AR 71860

553 N Pacific Coast Hwy
Ste 105
Redondo Beach, CA 90277

553 N Pacific Coast Hwy
Ste 505
Redondo Beach, CA 90277

553 N Pacific Coast Hwy
Ste B105
Redondo Beach, CA 90277

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1982441341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 N PACIFIC COAST HWY STE B-105",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772163",
            "telephone_number": "310-850-6279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6458 FISCHER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921305804",
            "telephone_number": "619-823-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEZMED",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-11",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "GUILLERMO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-823-1947",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family 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 Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.