Organization Active NPI

Christopher Joseph Gualtieri MD Apc

  • Ophthalmology Physician
  • San Diego, CA
National Provider Identifier
1992823959
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G73020 Issued in CA
Legal business name
CHRISTOPHER JOSEPH GUALTIERI MD APC
Practice address
3969 Fourth Avenue
Suite 300
San Diego, CA 92103-3165
Phone
(619) 688-2648
Fax
(619) 688-2626
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Authorized official

Name
Christopher Joseph Gualtieri, MDNPI 1790769156
Title
Corp President Ceo
Phone
(619) 688-2648

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X G73020 CA Primary

Addresses

Primary practice location

3969 Fourth Avenue
Suite 300
San Diego, CA 92103-3165

Mailing address

3969 Fourth Avenue
Suite 300
San Diego, CA 92103-3165
Phone (619) 688-2648

Other identifiers 1

IdentifierTypeStateIssuer
7398036MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050208001093 CA Part B Supplier - Clinic/Group Practice 3173574985 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

317 N El Camino Real
Ste 206
Encinitas, CA 92024
Phone (760) 479-0977

1020 E Vista Way
Vista, CA 92084
Phone (760) 940-1700

Practitioners & affiliated clinicians

Practitioners 3

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": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1992823959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3969 FOURTH AVENUE",
            "address_2": "SUITE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033165",
            "telephone_number": "619-688-2648",
            "fax_number": "619-688-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3969 FOURTH AVENUE",
            "address_2": "SUITE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033165",
            "telephone_number": "619-688-2648",
            "fax_number": "619-688-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER JOSEPH GUALTIERI MD APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "GUALTIERI",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CORP PRESIDENT CEO",
        "authorized_official_telephone_number": "619-688-2648",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G73020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7398036",
            "state": "CA"
        }
    ],
    "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 Dec 3, 2020; 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.