Frederick J de la Vega, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

A81923 Issued in CA

Legal business name

FREDERICK J DE LA VEGA, MD

Practice address

9834 Genesee Ave
411
La Jolla, CA 92037-1223

Phone

(858) 677-1755

Fax

(858) 677-1771

NPI assigned

Jun 19, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Frederick J. De la Vega, M.D.NPI 1427169069

Title

Owner

Phone

(858) 677-1755

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Frederick James Delavega, MD

  • Neurology Physician
  • La Jolla, CA
  • NPI 1427169069
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1083028898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23052 ALICIA PKWY",
            "address_2": "# 619",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926921643",
            "telephone_number": "714-808-9797",
            "fax_number": "714-808-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9834 GENESEE AVE",
            "address_2": "411",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371223",
            "telephone_number": "858-677-1755",
            "fax_number": "858-677-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK J DE LA VEGA, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "DE LA VEGA",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-677-1755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A81923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Franklin W. Lusby, M.D. Inc
• Shannon E Franklin, PSYD
• Robert Franks, M.D.
• Carol Frausto
• Fred J Simon, Jr., M.D.
• Kathryn Victoria Frederick Louv, RN, MN, FNP
• Marilyn Sara Freeman, PH.D., MFT
• Marcelo Freire, D.D.S.,PH.D., D.MED.
• Catherine Therese Frenette, M.D.
• Lauren Michelle Frey

• Specialist in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.