Individual provider Active NPI

Ernel Daleva Raymundo

  • Radiography Radiologic Technologist
  • San Diego, CA
National Provider Identifier
1083891550
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiography Radiologic TechnologistTaxonomy code 2471C3402X
License
RHF 78744 Issued in CA
Practice address
6236 Vista Santa Clara
San Diego, CA 92154-5626
Phone
(619) 947-3694
NPI assigned
Jan 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiography Radiologic Technologist 2471C3402X RHF 78744 CA Primary

Addresses

Primary practice location

6236 Vista Santa Clara
San Diego, CA 92154-5626

Mailing address

6236 Vista Santa Clara
San Diego, CA 92154-5626
Phone (619) 947-3694

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

State licenses

LicenseStateTypeSpecialty
RHF 78744CAMDRadiography Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1083891550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6236 VISTA SANTA CLARA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921545626",
            "telephone_number": "619-947-3694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6236 VISTA SANTA CLARA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921545626",
            "telephone_number": "619-947-3694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMUNDO",
        "first_name": "ERNEL",
        "middle_name": "DALEVA",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "CA",
            "license": "RHF 78744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; 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.