Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ingmar Niels Bastian, STUDENT

Individual provider Obstetrics & Gynecology Physician · NPI 1073263992

Ingmar Niels Bastian, STUDENT is an Obstetrics/Gynecology in San Diego, California. Graduated from University of Wisconsin School of Medicine in 2022, 4 years ago. Works from 7 locations. Licensed in California and Wisconsin.

Years since qualifying
4
Trained at
University of Wisconsin School of Medicine
Licensed in
CA, WI
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

200 W Arbor Dr
San Diego, CA 92103-9000
Phone: (800) 926-8273
Fax: (888) 539-8781
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (6)

  • 781 Garden View Ct Ste 200, Encinitas, CA 92024-2481 — (800) 926-8273
  • 9300 Campus Point Dr, La Jolla, CA 92037-1300 — (800) 926-8273
  • 4168 Front St, San Diego, CA 92103-2030 — (800) 926-8273
  • 4910 Directors Pl Ste 200, San Diego, CA 92121-3814 — (800) 926-8273
  • 16950 Via Tazon, San Diego, CA 92127-1607 — (800) 926-8273
  • 1 Baylor Plz, Houston, TX 77030-3411 — (832) 826-7354

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 208879 (CA)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence STUDENT (WI)

Record details

NPI number1073263992
Entity typeIndividual (Type 1)
GenderMale
Credentials STUDENT
Sole proprietorNo
NPI enumeratedMarch 24, 2022
Last updated in NPPESMay 5, 2026
Certification dateMay 5, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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