Andrew Bismark
Psychologist, Clinical in San Diego, CA. Individual provider (NPI-1).
NPI number1013423979
StatusActive
Last updated in NPPESDec 14, 2017
Details
- NPI
- 1013423979
- Entity type
- Individual (NPI-1)
- Name
- Andrew Bismark
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 14, 2017
- Last updated
- Dec 14, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 29689 | CA | Yes |
Practice location
3350 La Jolla Village DrSan Diego, CA 92161-0002
Phone 858-245-5825
Mailing address
3350 La Jolla Village DrSan Diego, CA 92161-0002
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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