Data Notice: All results sourced from the public CMS NPPES NPI Registry (45 CFR Part 162), for healthcare administrative use only (credentialing, billing, insurance verification). Not for law enforcement or legal proceedings. Not affiliated with CMS, HHS, or the US Government. Verify critical details at npiregistry.cms.hhs.gov. No queries stored.
Export Provider Record NPI 1366753022
Mina Kim WassonMD
Active
NPI Number1366753022
NPI TypeNPI-1 Individual
SpecialtyPediatrics
Provider Details
NPI1366753022
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2010-06-28
Last Updated2020-08-12
Mailing Address3880 Murphy Canyon Rd Ste 200
San Diego, CA 92123-4411
United States
Phone: (858) 636-4300 | Fax: (858) 636-4319
📍 View Map
Primary Practice Address12395 El Camino Real Ste 219
San Diego, CA 92130-3084
United States
Phone: (858) 793-1011 | Fax: (858) 793-1035
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes208000000X – PediatricsCAC167860
Export Provider Record NPI 1366753022
Search for More Providers
Use our free NPI Lookup tool to find any healthcare provider in the NPPES registry. Search NPI →

About NPI 1366753022

Mina Kim Wasson MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1366753022. The primary specialty listed is Pediatrics. The provider is located in San Diego, CA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2010-06-28. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1366753022?

NPI 1366753022 belongs to Mina Kim Wasson MD, a Pediatrics in San Diego, CA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1366753022 active?

The current status of NPI 1366753022 in the NPPES registry is Active. The record was last updated on 2020-08-12.

What specialty is NPI 1366753022?

NPI 1366753022 is classified under the taxonomy Pediatrics. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1366753022?

You can verify NPI 1366753022 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1366753022?

The primary practice address on file for NPI 1366753022 is 12395 El Camino Real Ste 219, San Diego, CA 92130-3084. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1366753022 issued?

NPI 1366753022 was first issued (enumerated) on 2010-06-28. The NPPES record was last updated on 2020-08-12.

Practice Location Map

Mina Kim Wasson is located at 12395 El Camino Real Ste 219, San Diego, CA. Use the map below to find directions or verify the practice location.

📍 12395 El Camino Real Ste 219, San Diego, CA 92130-3084  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Mina Kim Wasson. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1366753022. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
PediatricsC167860CA
Data Verified from CMS NPPES Last synced: 2026-08-18 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162