Healthcare Provider Details

I. General information

NPI: 1710419262
Provider Name (Legal Business Name): NADIYA GINZBURG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2185 CITRACADO PKWY
ESCONDIDO CA
92029-4159
US

IV. Provider business mailing address

8695 SPECTRUM CENTER BLVD
SAN DIEGO CA
92123-1489
US

V. Phone/Fax

Practice location:
  • Phone: 213-399-0179
  • Fax:
Mailing address:
  • Phone: 587-989-0838
  • Fax: 760-705-1533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA165689
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License NumberA165689
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA165689
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: