PRISTINE SURGICAL INCORPORATED
NPI 1336648500
Surgery in San Diego, CA

Q: What is Pristine Surgical Incorporated's NPI number?

The NPI number for Pristine Surgical Incorporated is 1336648500. It was assigned to this organization in the NPPES registry on February 2, 2018.

Q: What is Pristine Surgical Incorporated's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Active since February 02, 2018

6699 ALVARADO RD STE 2309, SAN DIEGO, CA 92120(619) 396-6637(619) 825-3406 Get Directions Write a Review

NPPES record last updated: March 10, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 10, 2020, Jul 31, 2018, Feb 28, 2018 (3 updates tracked since 2018).

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About Pristine Surgical Incorporated NPPES

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

PRISTINE SURGICAL INCORPORATED (NPI 1336648500) is a healthcare organization registered as a surgery in San Diego, California and active in the NPI registry since February 2018. The organization lists Vadim Avulov, President, as its authorized official.

NPPES Registry Identity

NPI1336648500

Entity TypeOrganization

Primary Taxonomy208600000X

Legal Business NamePRISTINE SURGICAL INCORPORATED

Location Address6699 ALVARADO RD STE 2309San Diego, CA 92120-5241

Mailing Address7905 Tommy DrSan Diego, CA 92119-1833

Phone(619) 396-6637

Fax(619) 825-3406

Organization SubpartNo

Authorized OfficialVadim AvulovPresident · (917) 602-4507

Enumeration DateFebruary 2, 2018

Last NPPES UpdateMarch 10, 20203 updates tracked since enumeration

NPPES CertifiedMarch 10, 2020

✔ NPI 1336648500 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in CA · 20A13344

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

6699 ALVARADO RD STE 2309, San Diego, CA 92120

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pristine Surgical Incorporated is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Pristine Surgical Incorporated, which bills Medicare for the services this clinician delivers.

Clinician (1)

Vadim Avulov, D.O.

General Surgery

NPI 1700121472

6699 ALVARADO RD STE 2309
San Diego, CA 92120

(619) 396-6637

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Pristine Surgical Incorporated's NPI number?

The NPI number for Pristine Surgical Incorporated is 1336648500. It was assigned to this organization in the NPPES registry on February 2, 2018.

Where is Pristine Surgical Incorporated located?

Pristine Surgical Incorporated is located at 6699 Alvarado Rd Ste 2309, San Diego, CA 92120. The listed phone number is (619) 396-6637.

What is Pristine Surgical Incorporated's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Pristine Surgical Incorporated enrolled in Medicare?

Yes. Pristine Surgical Incorporated is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pristine Surgical Incorporated?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (General Surgery) reassigns their Medicare billing to Pristine Surgical Incorporated. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Pristine Surgical Incorporated was last updated on March 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.