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  7. NPI Record 1528049897

DR. JERRY TSENG MD
Complete NPI Record 1528049897
Internal Medicine in San Diego, CA

NPI Status: Active since November 14, 2005

Contact Information

11939 RANCHO BERNARDO RD STE 100
SAN DIEGO, CA
ZIP 92128
Phone: (858) 674-2306
Fax: (858) 674-2322

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Name Prefix Text
  6. Provider Credential Text
  7. Provider First Line Business Mailing Address
  8. Provider Business Mailing Address City Name
  9. Provider Business Mailing Address State Name
  10. Provider Business Mailing Address Postal Code
  11. Provider Business Mailing Address Country Code If outside U S
  12. Provider Business Mailing Address Telephone Number
  13. Provider Business Mailing Address Fax Number
  14. Provider First Line Business Practice Location Address
  15. Provider Business Practice Location Address City Name
  16. Provider Business Practice Location Address State Name
  17. Provider Business Practice Location Address Postal Code
  18. Provider Business Practice Location Address Country Code If outside U S
  19. Provider Business Practice Location Address Telephone Number
  20. Provider Business Practice Location Address Fax Number
  21. Provider Enumeration Date
  22. Last Update Date
  23. Provider Gender Code
  24. Healthcare Provider Taxonomy Code 1
  25. Provider License Number 1
  26. Provider License Number State Code 1
  27. Healthcare Provider Primary Taxonomy Switch 1
  28. Other Provider Identifier 1
  29. Other Provider Identifier Type Code 1
  30. Other Provider Identifier State 1
  31. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1528049897. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1528049897
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: JERRY
The last name of the provider. If the provider is an individual, this is the legal name.
Provider Name Prefix Text: DR.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential Text: MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 11939 RANCHO BERNARDO RD STE 100
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: SAN DIEGO
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address State Name: CA
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address Postal Code: 921282074
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 8586742306
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 8586742322
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 11939 RANCHO BERNARDO RD STE 100
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: SAN DIEGO
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: CA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 921282074
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 8586742306
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 8586742322
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 11/14/2005
The fax number associated with the location address of the provider being identified.
Last Update Date: 12/13/2021
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Gender Code: M
The date that a record was last updated or changed.
Healthcare Provider Taxonomy Code 1: 207R00000X
The code designating the provider’s gender if the provider is a person.
Provider License Number 1: A76391
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number State Code 1: CA
Healthcare Provider Primary Taxonomy Switch 1: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Other Provider Identifier 1: 00A763910
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: CA
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No