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EDWARD JAESUNG AHN M.D.
NPI 1093805103
General Practice in San Diego, CA

Active since October 13, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 05D0894758 · Waiver
7750 DAGGET ST STE 108, SAN DIEGO, CA 92111(858) 571-1004(858) 571-1006 Get Directions Write a Review

NPPES record last updated: August 2, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Edward Jaesung Ahn M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDWARD JAESUNG AHN M.D. (NPI 1093805103) is an individual general practice provider in San Diego, California, licensed in California (A38304) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through November 20, 2026, and is a graduate of Other (1964).

NPPES Registry Identity

NPI1093805103
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameEDWARD JAESUNG AHNCredential: M.D.
Location Address7750 DAGGET ST STE 108San Diego, CA 92111-2235
Mailing Address7750 Dagget St Ste 108San Diego, CA 92111-2235 · (858) 571-1004 · Fax (858) 571-1006
Phone(858) 571-1004
Fax(858) 571-1006
Sole ProprietorYes
Medical School CMSOtherGraduated 1964
Enumeration DateOctober 13, 2006
Last NPPES UpdateAugust 2, 2022
NPPES CertifiedAugust 2, 2022
✔ NPI 1093805103 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in CA · A38304
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedFamily MedicineTaxonomy 207Q00000X · License A38304 (CA)
7750 DAGGET ST STE 108, San Diego, CA 92111
Open in Google Maps ↗

Other Identifiers 1

Medicaid00Q383040CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Edward Jaesung Ahn M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4385623164
PECOS Enrollment IDI20040715000749
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0894758

Edward J Ahn MD · San Diego, CA
Active · expires Nov 20, 2026
CLIA Number05D0894758
Laboratory TypeOther
Certificate Effective DateNovember 21, 2024
Certificate Expiration DateNovember 20, 2026
Laboratory DirectorEdward J. Ahn
Laboratory Phone(858) 571-1004
Laboratory LocationEdward J Ahn MD7750 Dagget Street, #108, San Diego, CA 92111
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
107 services29 patients
Insertion of needle into vein (3 years or older) 36410
This procedure involves placing a small needle into a vein, typically in the arm. It's done to collect blood for testing or to deliver medication. You may feel a quick pinch, but it's usually over in seconds. It's a common, safe procedure.
19 services17 patients

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HARVARD MEDICAL GROUP INC
General Practice
7750 DAGGET ST STE 108
SAN DIEGO, CA 92111
San Diego County (858) 571-1004

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edward Ahn's NPI number?

The NPI number for Edward Ahn is 1093805103. It was assigned to this individual provider in the NPPES registry on October 13, 2006.

Where is Edward Ahn located?

Edward Ahn practices at 7750 Dagget St Ste 108, San Diego, CA 92111. The listed phone number is (858) 571-1004.

What is Edward Ahn's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Edward Ahn enrolled in Medicare?

Yes. Edward Ahn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Does Edward Ahn hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0894758) is associated with this NPI, valid through November 20, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Edward Ahn was last updated on August 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.