Unknown Individual – Family Medicine Physician, NPI 1023076858

Unknown Individual is a healthcare provider. based in San diego, California. specializing in Family Medicine Physician. They hold a License No. G72291 (CA). The NPI Number for Unknown Individual is 1023076858

Main info

Organization
Inactive
36 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1023076858
Phone
Not provided
Address
PO BOX 232410
Deactivation Date
4 September 2025

Doctor Profile

Medical School Name
R FRANKLIN UNIVERSITY OF MED & SCI/CHICAGO MEDICAL SCHOOL
Secondary Phone
8586577000
Graduation Year
1990 (36 years ago)
PAC ID
6608061825
Group Practice PAC ID
3577476761
Professional Enrollment ID
I20101115000025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • PO BOX 232410

    SAN DIEGO, CA 921932410

    Phone:

    Type: Mailing

  • UC San Diego Medical Center, 200, West Arbor Drive, Uptown Medical Complex, Hillcrest, San Diego, San Diego County, California, 92103, United States

    SAN DIEGO, CA 921039000

    Phone: (800) 926-8273

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes2524$0
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Insurance plans in this area (ZIP 92193)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
SPORTS MEDICINECA90670Pneumococcal vaccine for injection into muscle1313

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3577476761View full group profile

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1023076858.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect San Diego, California as a primary anchor for Unknown Individual unless the record lists multiple sites.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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