Individual provider Active NPI

Avelardo V Malvido, MSN, FNP, APRN

  • Adult Health Nurse Practitioner
  • Corona, CA
National Provider Identifier
1053093245
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95026371 Issued in CA
Practice address
1492 W 6TH St Ste M
Corona, CA 92882-6529
Phone
(949) 491-9616
NPI assigned
Aug 7, 2023
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95026371 CA Primary

Addresses

Primary practice location

1492 W 6TH St Ste M
Corona, CA 92882-6529

Mailing address

1492 W 6TH St Ste M
Corona, CA 92882-6529
Phone (949) 491-9616

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 Science - Nursing

State licenses

LicenseStateTypeSpecialty
95026371CAMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1053093245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1492 W 6TH ST STE M",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928826529",
            "telephone_number": "949-491-9616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 W 6TH ST STE M",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928826529",
            "telephone_number": "949-491-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALVIDO",
        "first_name": "AVELARDO",
        "middle_name": "V",
        "credential": "MSN, FNP, APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95026371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.