Provider Demographics
NPI:1801992839
Name:HELTON, DEREK ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:DEREK
Middle Name:ANTHONY
Last Name:HELTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 232410
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-2410
Mailing Address - Country:US
Mailing Address - Phone:800-926-8273
Mailing Address - Fax:
Practice Address - Street 1:910 SYCAMORE AVE
Practice Address - Street 2:SUITE 270
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-7832
Practice Address - Country:US
Practice Address - Phone:760-598-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76208207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0163860OtherGHI
CA00A762080Medicaid
CA0163860OtherGHI
CA00A762080Medicaid