Sioud Idris

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

E3301391 Issued in CA

Practice address

23792 Landisview Ave
Lake Forest, CA 92630-5126

Phone

(949) 899-7959

NPI assigned

Apr 7, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1073208799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23792 LANDISVIEW AVE",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926305126",
            "telephone_number": "949-899-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23792 LANDISVIEW AVE",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926305126",
            "telephone_number": "949-899-7959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDRIS",
        "first_name": "SIOUD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-07",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CA",
            "license": "E3301391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel Rocio Hui, PT
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• Innovative Lake Forest Operations, LLC

• Basic Emergency Medical Technician in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Basic Emergency Medical Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.