Active NPI
Isamel Paul Yturralde, DDS
- Dentist
- Brawley, CA
National Provider Identifier
1003973470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 24669
- Practice address
- 1166 K St
Brawley, CA 92227-2737 - Phone
- (760) 344-3583
- NPI assigned
- Jan 3, 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 24669 | CA | Primary |
Addresses
Primary practice location
1166 K St
Brawley, CA 92227-2737
Mailing address
1166 K St
Brawley, CA 92227-2737
Phone (760) 344-9951
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24699 | Other | CA | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24669 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324425600000",
"number": "1003973470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1166 K ST",
"city": "BRAWLEY",
"state": "CA",
"postal_code": "922272737",
"telephone_number": "760-344-9951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1166 K ST",
"city": "BRAWLEY",
"state": "CA",
"postal_code": "922272737",
"telephone_number": "760-344-3583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YTURRALDE",
"first_name": "ISAMEL",
"middle_name": "PAUL",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2011-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "24669",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "24699",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brawley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.