ETIENNE MARIA VASCONCELLOS D MACEDO (NPI# 1265951172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265951172 |
| Entity Type | Individual |
| Full Name | ETIENNE MARIA VASCONCELLOS D MACEDO |
| Credential | MD |
| Practice Address |
9452 Medical Center Dr # Mc0982 La Jolla CA 92037-1337 |
| Mailing Address |
200 W Arbor Dr San Diego CA 92103-1911 |
| Practice Telephone | 8582462085 |
| Mailing Telephone | 8586578000 |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2018-07-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
F498 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
9452 MEDICAL CENTER DR # MC0982 |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92037-1337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982221768 | Equip Health Medical, PC | Clinic/Center | 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 | 2020-06-29 |
| 1134745474 | Brenda Kay Wiederhold | Psychologist | Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 | 2020-06-23 |
| 1316581598 | Kathleen M Blechertas | Physical Therapist | 9888 Genesee, Lj19, La Jolla, CA 92037 | 2019-10-31 |
| 1316592876 | Kevin Yanyan Li | Student in an Organized Health Care Education/Training Program | 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 | 2019-08-01 |
| 1407400542 | Juan J Salmeron | Dentist | Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 | 2019-07-26 |
| 1609428598 | Nicole Whitney Mark | Physician Assistant | 8103 Caminito Sonoma, La Jolla, CA 92037 | 2019-07-11 |
| 1700357936 | Cecelia Rose Greene/pendzich | Mastectomy Fitter | 7760 Fay Ave, Suite M., La Jolla, CA 92037 | 2018-12-16 |
| 1740765890 | Jeenal Ankit Gordhandas | Student in an Organized Health Care Education/Training Program | East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 | 2018-09-25 |
| 1306325220 | Lisa Beth Perlov Marks | Marriage & Family Therapist | 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 | 2018-08-10 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| Find all providers in zip 92037 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457797169 | Clyde Houghton Beck, Jr. Jr. | Internal Medicine | 6412 Cardeno Dr, La Jolla, CA 92037 | 2013-05-21 |
| 1275822082 | Karo Torosian | Internal Medicine | 9834 Genesee Ave Ste 312, La Jolla, CA 92037-1221 | 2011-04-01 |
| 1477880102 | Pranav Sandilya Garimella | Internal Medicine | 9452 Medical Center Dr # Mc7424, La Jolla, CA 92037-1337 | 2009-11-17 |
| 1942476403 | Richard Villalobos | Internal Medicine | 2363 Aveinida De La Playa, La Jolla, CA 92037 | 2008-05-05 |
| 1578519203 | Dena E Rifkin | Internal Medicine | 9500 Gilman Drive Va Medical Center, 9111h, La Jolla, CA 92093-9111 | 2006-05-25 |
| 1437154143 | Mark M. Boiskin | Internal Medicine | 9834 Genesee Ave, Ste 312, La Jolla, CA 92037-1223 | 2005-06-17 |
| 1528542503 | Benjamin Digrazia | Internal Medicine | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2018-09-17 |
| 1083972483 | Yogita Lakhera | Internal Medicine | 9834 Genesee Ave, Suite 312, La Jolla, CA 92037-1223 | 2012-04-24 |
| 1689719551 | Melanie A. Farrell, M.d., A Professional Medical Corporation | Internal Medicine | 9834 Genesee Ave, Suite 312, La Jolla, CA 92037-1223 | 2007-02-20 |
| 1689733172 | James C Rice | Internal Medicine | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2006-12-08 |
| Find all providers in LA JOLLA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.