Individual provider Active NPI

Kristian Ferdinand Dizon

  • Independent Duty Corpsman
  • San Diego, CA
National Provider Identifier
1992597546
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
34800 Bob Wilson Dr
San Diego, CA 92134-1098
Phone
(925) 813-5657
NPI assigned
May 20, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X CA Primary

Addresses

Primary practice location

34800 Bob Wilson Dr
San Diego, CA 92134-1098

Mailing address

8488 New Salem St Unit 68
San Diego, CA 92126-2339
Phone (925) 813-5657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1992597546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8488 NEW SALEM ST UNIT 68",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262339",
            "telephone_number": "925-813-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "925-813-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIZON",
        "first_name": "KRISTIAN",
        "middle_name": "FERDINAND",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "CA",
            "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 May 20, 2025; 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.