Organization Active NPI

Dalilah Restrepo MD, a Medical Corporation

  • Infectious Disease Physician
  • Fountain Valley, CA
National Provider Identifier
1013677624
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
DALILAH RESTREPO MD, A MEDICAL CORPORATION
Practice address
17100 Euclid St
Fountain Valley, CA 92708
Phone
(917) 376-0967
NPI assigned
Dec 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dalilah Restrepo, MDNPI 1396816393
Title
President
Phone
(917) 376-0967

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

17100 Euclid St
Fountain Valley, CA 92708

Mailing address

3334 E Coast Hwy Ste 655
Corona del Mar, CA 92625-2328
Phone (917) 376-0967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220112002237 CA Part B Supplier - Clinic/Group Practice 3375935851 Receives reassigned benefits from 1 practitioner
Practice locations: Fountain Valley, CA

National Provider Directory

National Provider Directory

Locations

3334 Pacific Coast Hwy
Corona del Mar, CA 92625
Phone (949) 631-4890

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640131200000",
    "number": "1013677624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 E COAST HWY STE 655",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252328",
            "telephone_number": "917-376-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 EUCLID ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "917-376-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALILAH RESTREPO MD, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-22",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "RESTREPO",
        "authorized_official_first_name": "DALILAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-376-0967",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.