Organization Active NPI

Yaroslav Kushnir M.D., Inc

  • Psychiatry Physician
  • Chula Vista, CA
National Provider Identifier
1992061923
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G24238 Issued in CA
Legal business name
YAROSLAV KUSHNIR M.D., INC
Practice address
709 Third Ave
Chula Vista, CA 91910-5803
Phone
(619) 585-3000
Fax
(619) 585-3002
NPI assigned
Apr 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Authorized official

Name
Yaroslav Kushnir, M.D.
Title
Owner
Phone
(619) 585-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X G24238 CA Primary

Addresses

Primary practice location

709 Third Ave
Chula Vista, CA 91910-5803

Mailing address

709 Third Ave
Chula Vista, CA 91910-5803
Phone (619) 585-3000

Other identifiers 1

IdentifierTypeStateIssuer
00G242380MedicaidCA

National Provider Directory

National Provider Directory

Locations

709 Third Ave
Chula Vista, CA 91910
Phone (619) 585-3000

5088 Elm St
San Diego, CA 92102
Phone (619) 585-3000

Practitioners & affiliated clinicians

Practitioners 2

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": "1333497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333497600000",
    "number": "1992061923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 THIRD AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105803",
            "telephone_number": "619-585-3000",
            "fax_number": "619-585-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 THIRD AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105803",
            "telephone_number": "619-585-3000",
            "fax_number": "619-585-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAROSLAV KUSHNIR M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-04",
        "last_updated": "2012-04-04",
        "status": "A",
        "authorized_official_last_name": "KUSHNIR",
        "authorized_official_first_name": "YAROSLAV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-585-3000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G24238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G242380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.