NPIMap

Organization Active NPI

Jacqueline Sevilla MD a Medical Corporation

  • Obstetrics & Gynecology Physician
  • Indio, CA
National Provider Identifier
1114301298
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A87837 Issued in CA
Legal business name
JACQUELINE SEVILLA MD A MEDICAL CORPORATION
Practice address
81715 Doctor Carreon Blvd
A-1
Indio, CA 92201-0601
Phone
(760) 323-9309
Fax
(760) 610-8995
NPI assigned
Jul 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
Jacqueline Sevilla, MDNPI 1518023209
Title
President
Phone
(760) 342-2295

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X A87837 CA Primary

Addresses

Primary practice location

81715 Doctor Carreon Blvd
A-1
Indio, CA 92201-0601

Mailing address

81715 Doctor Carreon Blvd
A-1
Indio, CA 92201-0601
Phone (760) 323-9309

National Provider Directory

National Provider Directory

Locations

81715 Doctor Carreon Blvd
Ste A1
Indio, CA 92201
Phone (760) 323-9309

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1114301298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81715 DOCTOR CARREON BLVD",
            "address_2": "A-1",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922010601",
            "telephone_number": "760-323-9309",
            "fax_number": "760-610-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81715 DOCTOR CARREON BLVD",
            "address_2": "A-1",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922010601",
            "telephone_number": "760-323-9309",
            "fax_number": "760-610-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE SEVILLA MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "SEVILLA",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-342-2295",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A87837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.