Provider Demographics
NPI:1780669283
Name:MORTON, ASA D (MD)
Entity Type:Individual
Prefix:
First Name:ASA
Middle Name:D
Last Name:MORTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:3939 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3002
Mailing Address - Country:US
Mailing Address - Phone:619-296-8525
Mailing Address - Fax:619-692-0229
Practice Address - Street 1:3939 3RD AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-3002
Practice Address - Country:US
Practice Address - Phone:619-296-8525
Practice Address - Fax:619-692-0229
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG68919207W00000X, 207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0092690Medicaid
W13418Medicare ID - Type Unspecified
F80254Medicare UPIN