Active NPI
Ruben Garcia de Alba, PA-C
- Physician Assistant
- Los Angeles, CA
National Provider Identifier
1003965542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA-15262
- Practice address
- 4425 S Central Ave
Los Angeles, CA 90011-3629 - Phone
- (323) 908-4200
- Fax
- (323) 908-4262
- NPI assigned
- Jan 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-15262 | CA | Primary |
Addresses
Primary practice location
4425 S Central Ave
Los Angeles, CA 90011-3629
Mailing address
P.O. Box 14545
P.O. Box 14545
Torrance, CA 90501
Phone (323) 908-4200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160616000582 | CA | Order and Referring Only - Physician Assistant | 4385935667 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-15262 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003965542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 14545",
"address_2": "P.O. BOX 14545",
"city": "TORRANCE",
"state": "CA",
"postal_code": "90501",
"telephone_number": "323-908-4200",
"fax_number": "323-908-4262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4425 S CENTRAL AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900113629",
"telephone_number": "323-908-4200",
"fax_number": "323-908-4262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA DE ALBA",
"first_name": "RUBEN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA-15262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.