Active NPI
Edward P. Padilla, MA, MS, RDN
- Registered Dietitian
- Poway, CA
National Provider Identifier
1013766393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86146774
- Practice address
- 12738 La Vista Way
Poway, CA 92064-5511 - Phone
- (858) 218-4994
- NPI assigned
- May 17, 2024
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86146774 | CA | Primary |
Addresses
Primary practice location
12738 La Vista Way
Poway, CA 92064-5511
Mailing address
10990 San Diego Mission Rd
San Diego, CA 92108-2417
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
- Credentials
- Master of Arts, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86146774 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715904000000",
"number": "1013766393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10990 SAN DIEGO MISSION RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921082417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12738 LA VISTA WAY",
"city": "POWAY",
"state": "CA",
"postal_code": "920645511",
"telephone_number": "858-218-4994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PADILLA",
"first_name": "EDWARD",
"middle_name": "P.",
"credential": "MA, MS, RDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-17",
"last_updated": "2024-05-17",
"certification_date": "2024-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86146774",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poway, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.