DOUGLAS JULES ELLISON (NPI# 1922022029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922022029 |
| Entity Type | Individual |
| Full Name | DOUGLAS JULES ELLISON |
| Credential | M.D. |
| Practice Address |
7592 Metropolitan Dr Suite 405-407 San Diego CA 92108-4428 |
| Mailing Address |
7592 Metropolitan Dr Suite 405 San Diego CA 92108-4428 |
| Practice Telephone | 6192974900 |
| Practice Fax Number | 6192975460 |
| Mailing Telephone | 6193258726 |
| Mailing Fax Number | 6193258728 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2008-06-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZH0000X |
Pathology Specialization: Hematology |
G53026 | CA | Allopathic & Osteopathic Physicians |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
G53026 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G530260 | 05 |
| Street Address |
7592 METROPOLITAN DR SUITE 405-407 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92108-4428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184698391 | John Lee Grimwood | Pathology | 7592 Metropolitan Dr, Ste 405, San Diego, CA 92108-4428 | 2006-02-14 |
| 1174836894 | San Diego Pathologists Medical Group Inc | Pathology | 7592 Metropolitan Dr, Suite 405, San Diego, CA 92108-4428 | 2010-07-22 |
| 1598083909 | Autumn Rose Phillips | Psychologist | 7592 Metropolitan Dr, Ste 400, San Diego, CA 92108-4428 | 2010-05-10 |
| 1700108776 | Chronic Pain Associates, P.C. | Rehabilitation Practitioner | 7592 Metropolitan Dr, Suite 401, San Diego, CA 92108-4428 | 2010-02-18 |
| 1396958559 | William Joseph Watts | Pathology | 7592 Metropolitan Dr, Suite 405-407, San Diego, CA 92108-4428 | 2007-05-07 |
| 1588757215 | Tyler P Youngkin | Pathology | 7592 Metropolitan Dr, Suite 405-407, San Diego, CA 92108-4428 | 2006-10-02 |
| 1427066836 | Carla Stayboldt | Pathology | 7592 Metropolitan Dr, Suite 405-407, San Diego, CA 92108-4428 | 2006-08-03 |
| 1194732644 | Bruce Alan Robbins | Pathology | 7592 Metropolitan Dr, Suite 405-407, San Diego, CA 92108-4428 | 2006-08-01 |
| 1174530612 | David John Francis | Pathology | 7592 Metropolitan Dr, Suite 405-407, San Diego, CA 92108-4428 | 2006-08-01 |
| 1265449748 | Nancy Lee Harrison | Pathology | 7592 Metropolitan Dr, Suite 405-407, San Diego, CA 92108-4428 | 2006-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902801 | Keri Castaneda | Behavior Technician | 025 Camino Del Rio South Suite 101, San Diego, CA 92108 | 2020-11-06 |
| 1457963738 | Diyana Giorgees | Case Manager/Care Coordinator | 5005 Texas Street, St. 203, San Diego, CA 92108 | 2020-08-19 |
| 1780211896 | Lori Mildred Jerman | Marriage & Family Therapist | Healthy Minds Counseling Services, 1455 Frazee Road, Suite 880, San Diego, CA 92108 | 2020-03-26 |
| 1285260737 | Demetrius Anderson | Counselor | Telecare Corporation Ihot, 1660 Hotel Circle North, Suite 101, San Deigo, CA 92108 | 2020-03-17 |
| 1033742465 | Dasc Medical Inc | Durable Medical Equipment & Medical Supplies | 5520 Gill Village Way, 907, San Diego, CA 92108 | 2020-02-13 |
| 1508401092 | Chanda Denee Kizer | Marriage & Family Therapist | 3517 Camino Del Rio N, Suite 407, San Diego, CA 92108 | 2019-11-08 |
| 1225695562 | Jenna Rose Shurer | Nurse Practitioner | 5030 Camino De La Siesla Ste 106, San Diego, CA 92108 | 2019-05-22 |
| 1952967812 | Martha Kebede Mekonen | Chiropractor | 2667 Camino Del Rio South, Suite #313, San Diego, CA 92108 | 2019-05-16 |
| 1053886135 | Andrea Jiselly Munoz | Behavior Technician | 3505 Camino Del Rio South, Suite 200, San Diego, CA 92108 | 2018-10-04 |
| 1386128916 | Sarah Elisabeth Smith | Counselor | 7575 Metropolitan Dr., San Diego, CA 92108 | 2018-09-19 |
| Find all providers in zip 92108 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| 1548786163 | Uc San Diego | Pathology | 200 West Arbor Drive Mc 8320, San Diego, CA 92103 | 2017-08-15 |
| 1669818456 | Stephanie Erin Muller | Pathology | 9295 Farnham Street, Suite 100, San Diego, CA 92123 | 2013-05-20 |
| 1740571264 | Lynn A Lancaster | Pathology | 4633 E Talmadge Dr, San Diego, CA 92116-4829 | 2011-05-02 |
| 1255633442 | Lawrence Browning Willes | Pathology | 200 W Arbor Dr # Mc8720, San Diego, CA 92103-9001 | 2010-11-22 |
| 1063724920 | Veena Singh | Pathology | 9640 Towne Centre Dr Ste 200, San Diego, CA 92121-1963 | 2010-07-08 |
| 1194056820 | James Russell Nickel | Pathology | 3446 Hancock St, Suite C, San Diego, CA 92110-4306 | 2010-01-20 |
| 1386832640 | Aamir Ahsan | Pathology | 9295 Farnham St Ste 100, San Diego, CA 92123-1254 | 2007-10-11 |
| 1437340445 | Maria Lourdes Fernandez Reyes | Pathology | 6371 Rancho Mission Rd, Unit 2, San Diego, CA 92108-2016 | 2007-08-05 |
| 1316030984 | James J Underwood | Pathology | 9853 Pacific Heights Blvd, Ste B, San Diego, CA 92121-4721 | 2006-10-02 |
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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.