Individual provider Active NPI

Jaime H Delgado, M.D.

  • Diagnostic Radiology Physician
  • Anaheim, CA
National Provider Identifier
1104878727
Registry record updated Jan 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A24411 Issued in CA
Practice address
1025 S Anaheim Blvd
Anaheim, CA 92805-5806
Phone
(310) 329-2469
Fax
(310) 329-0176
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A24411 CA Primary

Addresses

Primary practice location

1025 S Anaheim Blvd
Anaheim, CA 92805-5806

Mailing address

PO Box 5333
Torrance, CA 90510-5333
Phone (310) 329-2469

Other identifiers 1

IdentifierTypeStateIssuer
00A244110MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051024001141 CA Practitioner - Diagnostic Radiology 2466479985 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A24411CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John P Anderson MD Russell M Perry MD and Mark a Sharzer MD a Med CRP CurrentSince Sep 19, 2018 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology Past Accepting new patients
Beverly Radiology Medical Group Diagnostic Radiology Past Accepting new patients

Locations

1025 S Anaheim Blvd
Anaheim, CA 92805
Phone (714) 533-6220

17772 Beach Blvd
Huntington Beach, CA 92647
Phone (714) 842-1473

7901 Walker St
La Palma, CA 90623
Phone (562) 424-2900

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199750400000",
    "number": "1104878727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5333",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905105333",
            "telephone_number": "310-329-2469",
            "fax_number": "310-329-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S ANAHEIM BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928055806",
            "telephone_number": "310-329-2469",
            "fax_number": "310-329-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADO",
        "first_name": "JAIME",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A24411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A244110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.