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NPI 1053881003 · Nurse Practitioner · La Mesa, CA
Provider details
- NPI number
- 1053881003
- Entity type
- Organization
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Enrique Chung, Cfo(619) 253-6451
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4579 Maple Ave Ste 1
La Mesa, CA 91941-3154
Phone: (619) 253-6451
Street-level locationGet directions
Mailing address
1215 Hopland Ct
Chula Vista, CA 91913-1438
Additional practice locations (1)
- 6244 El Cajon Blvd Ste 29San Diego, CA 92115-3918Phone: (888) 628-6680Fax: (888) 628-6680
Registry dates
- Enumerated
- 2018-12-03
- Last updated
- 2020-03-13
- Certified
- 2020-03-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.