Carlos A Cuellar, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA12339 Issued in CA

Practice address

Student Health Services Csu Chico
Chico, CA 95929-0001

Phone

(530) 898-5241

NPI assigned

Mar 21, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chico Immediate Care Medical Center, Inc.

  dba Premiere Primary Care

  • Clinic/Center
  • Chico, CA
  • NPI 1669884250
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093831117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DONNER LN",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959284167",
            "telephone_number": "530-894-7354",
            "fax_number": "530-898-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STUDENT HEALTH SERVICES CSU CHICO",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959290001",
            "telephone_number": "530-898-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUELLAR",
        "first_name": "CARLOS",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA12339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Crowson, CPHT
• Steven C. Crowson, D.M.D.
• Julia Ann Cruse, PA
• David Scott Cruzan, RPH.
• Megan Csoto
• Janine Renee Cuellar, LCSW
• Mariela Cuna
• Amanda Rose Cunningham, BA
• John Curet
• Marjorie Cusick, MFT

• Medical Physician Assistant in Chico, CA
• Providers in Chico, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.