OrganizationActive
Shadowridge Medical Group
NPI 1639398613 · Specialist · Vista, CA
Shadowridge Medical Group is a Specialist organization in Vista, CA (NPI 1639398613).
Provider details
- NPI number
- 1639398613
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Todd Wine, Physician(760) 727-6920
- License
- G045531 (CA)
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
1680 S Melrose Dr Ste 105
Vista, CA 92081-5472
Phone: (760) 727-6920
Fax: (760) 727-3368
Street-level locationGet directions
Mailing address
1680 S Melrose Dr Ste 105
Vista, CA 92081-5472
Registry dates
- Enumerated
- 2007-04-25
- Last updated
- 2020-08-22
Frequently asked questions
- What is Shadowridge Medical Group's NPI number?
- Shadowridge Medical Group's National Provider Identifier (NPI) is 1639398613, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Shadowridge Medical Group?
- Shadowridge Medical Group is classified in the NPPES registry as Specialist (Other Service Providers).
- Where is Shadowridge Medical Group located?
- Shadowridge Medical Group's practice location on file with NPPES is 1680 S Melrose Dr Ste 105, Vista, CA 92081-5472.
- What is Shadowridge Medical Group's phone number?
- The practice phone number listed in the NPPES registry for Shadowridge Medical Group is (760) 727-6920.
- Who is the authorized official for Shadowridge Medical Group?
- The authorized official listed on Shadowridge Medical Group's NPPES record is Todd Wine, Physician. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Shadowridge Medical Group's NPI active?
- Yes — Shadowridge Medical Group's NPI (1639398613) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.