OrganizationActive
Duangtavan Sourivong
NPI 1285821389 · Methadone Clinic · San Diego, CA
Duangtavan Sourivong is a Methadone Clinic organization in San Diego, CA (NPI 1285821389).
Provider details
- NPI number
- 1285821389
- Entity type
- Organization
- Primary specialty
- Methadone ClinicAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Bobby Stearns, Clinic Director(619) 262-8000
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
3940 Home Ave
San Diego, CA 92105-5952
Phone: (619) 262-8000
Street-level locationGet directions
Mailing address
4852 Jarrett Ct
San Diego, CA 92113-3598
Registry dates
- Enumerated
- 2007-10-02
- Last updated
- 2007-10-02
Frequently asked questions
- What is Duangtavan Sourivong's NPI number?
- Duangtavan Sourivong's National Provider Identifier (NPI) is 1285821389, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Duangtavan Sourivong?
- Duangtavan Sourivong is classified in the NPPES registry as Methadone Clinic (Ambulatory Health Care Facilities).
- Where is Duangtavan Sourivong located?
- Duangtavan Sourivong's practice location on file with NPPES is 3940 Home Ave, San Diego, CA 92105-5952.
- What is Duangtavan Sourivong's phone number?
- The practice phone number listed in the NPPES registry for Duangtavan Sourivong is (619) 262-8000.
- Who is the authorized official for Duangtavan Sourivong?
- The authorized official listed on Duangtavan Sourivong's NPPES record is Bobby Stearns, Clinic Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Duangtavan Sourivong's NPI active?
- Yes — Duangtavan Sourivong's NPI (1285821389) is active in the NPPES registry as of the last update on 2007-10-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.