BRIAN REBOLLEDO (NPI# 1104119494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104119494 |
| Entity Type | Individual |
| Full Name | BRIAN REBOLLEDO |
| Credential | M.D. |
| Practice Address |
10710 N Torrey Pines Rd La Jolla CA 92037-1035 |
| Mailing Address |
10790 Rancho Bernardo Rd San Diego CA 92127-5705 |
| Practice Telephone | 8585547980 |
| Mailing Telephone | 8585547980 |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2019-12-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
A140481 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
10710 N TORREY PINES RD |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92037-1035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083615512 | George R Baehr | Emergency Medicine | 10710 N Torrey Pines Rd, La Jolla, CA 92037-1035 | 2005-08-09 |
| 1215547856 | Lori Hernandez | Pharmacist | 10710 N Torrey Pines Rd, La Jolla, CA 92037-1035 | 2020-08-07 |
| 1871101527 | Holly V Fyffe | Audiologist | 10710 N Torrey Pines Rd, La Jolla, CA 92037-1035 | 2020-07-20 |
| 1659810497 | Steven Jaklic | Physician Assistant | 10710 N Torrey Pines Rd, Mail Drop Ms 116, La Jolla, CA 92037-1027 | 2017-02-13 |
| 1225410582 | David Alan Brethouwer | Orthopaedic Surgery | 10710 N Torrey Pines Rd, La Jolla, CA 92037-1035 | 2015-06-23 |
| 1396123857 | Eric Toshio Owashi | Orthopaedic Surgery | 10710 N Torrey Pines Rd, La Jolla, CA 92037-1035 | 2015-05-15 |
| 1760825418 | Emily Anne Nagler | Internal Medicine | 10710 N Torrey Pines Rd, La Jolla, CA 92037-1035 | 2013-04-12 |
| 1497015614 | Dana M. Vaccari | Internal Medicine | 10710 N Torrey Pines Rd, La Jolla, CA 92037-1035 | 2012-05-22 |
| 1215183066 | Anna Andranik Kulidjian | Orthopaedic Surgery | 10710 N Torrey Pines Rd, La Jolla, CA 92037-1035 | 2008-08-12 |
| 1972769750 | John-michael Li | Psychiatry & Neurology | 10710 N Torrey Pines Rd, La Jolla, CA 92037-1035 | 2008-07-31 |
| Find all providers in the same location | ||||
| 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 | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013117183 | Kian Raiszadeh | Orthopaedic Surgery | 2725 Ridgegate Row, La Jolla, CA 92037-0915 | 2007-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790341618 | Casey S Revenko | Orthopaedic Surgery | 2999 Regent St Ste 225, Berkeley, CA 94705-2117 | 2019-05-15 |
| 1225504301 | Amgad Alfred | Orthopaedic Surgery | 18145 Us Highway 18 Ste D, Apple Valley, CA 92307-2210 | 2018-10-16 |
| 1386136430 | Valley River Orthopedics and Sports Medicine | Orthopaedic Surgery | Valley River Orthopedics & Sports Medicine Inc, 3329 G St Ste A, Merced, CA 95340 | 2018-06-05 |
| 1073026696 | Optimal Physician Surgical Group | Orthopaedic Surgery | 25067 Jim Bridger Rd, Hidden Hills, CA 91302-1128 | 2017-11-06 |
| 1336669456 | Beach Cities Orthopedics Surgery Center, LLC | Orthopaedic Surgery | 400 S Sepulveda Blvd Ste 110, Manhattan Beach, CA 90266-6814 | 2017-06-20 |
| 1750818860 | Health Link Medical Group Inc | Orthopaedic Surgery | 899 Northgate Dr Ste 400, San Rafael, CA 94903-3667 | 2017-05-19 |
| 1962861476 | Mehta Orthopedics | Orthopaedic Surgery | 32145 Alvarado Niles Rd Ste 209, Union City, CA 94587-2930 | 2016-02-12 |
| 1649646282 | Bay Area Surgical Specialists, Inc. A Medical Corporation | Orthopaedic Surgery | 5924 Stoneridge Dr Ste 202, Pleasanton, CA 94588-5400 | 2015-08-18 |
| 1114346111 | Sean Robinson | Orthopaedic Surgery | 7551 Timberlake Way Ste 200, Sacramento, CA 95823-5422 | 2014-04-08 |
| 1851717938 | William R Campbell Do Prof Corp | Orthopaedic Surgery | 1 Daniel Burnham Ct Ste 365c, San Francisco, CA 94109-5490 | 2014-03-12 |
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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.