Unknown Individual – Family Medicine Physician, NPI 1790749208
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
480, 4th Avenue, Chula Vista, San Diego County, California, 91910, United States
SUITE 202
CHULA VISTA, CA 919104410
Phone: (619) 427-3361
Fax: (619) 427-6821
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 29 Open Payments records for all available years, with a total value of $615.
Total Amount is formed as General ($615) + Research ($0) + Ownership ($0) = $615.
Last reported payment date: 2024-10-08 • Largest payer in this snapshot: ABBVIE INC. ($134).
Total Amount
$615
General + Research + Ownership
Payments
29
Total payment records
General Amount
$615
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $134 |
| Radius Health, Inc. | $62 |
| Baxter Healthcare | $61 |
| Dexcom, Inc. | $57 |
| Amgen Inc. | $41 |
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 255 | 92 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 31 | 24 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 29 | 21 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 20 | 20 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 18 | 18 | $0 |
Insurance plans in this area (ZIP 91910)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | CA | 90670 | Pneumococcal vaccine for injection into muscle | 24 | 24 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Osteopathic Manipulative Medicine, Family Practice | CA | |
| Family Practice | CA | |
| Family Practice | CA | |
| Family Practice | CA | |
| Family Practice | CA | |
| Family Practice | CA | |
| Family Practice | CA | |
| Family Practice | CA | |
| E N D O C R I N O L O G Y | OR |
Reviews
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