Active NPI
Oscar Iglesias
- Substance Abuse Rehabilitation Facility
- Garden Grove, CA
National Provider Identifier
1124115456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- License
- 101YA0400X
- Practice address
- 9842 13TH St Ste B
Garden Grove, CA 92844-3171 - Phone
- (714) 531-4624
- Fax
- (714) 531-1189
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | 101YA0400X | CA | Primary |
Addresses
Primary practice location
9842 13TH St Ste B
Garden Grove, CA 92844-3171
Mailing address
9842 13TH St Ste B
Garden Grove, CA 92844-3171
Phone (714) 531-4624
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1001YA0400X | Other | CA | HOUSE MANAGER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 101YA0400X | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124115456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9842 13TH ST STE B",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928443171",
"telephone_number": "714-531-4624",
"fax_number": "714-531-1189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9842 13TH ST STE B",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928443171",
"telephone_number": "714-531-4624",
"fax_number": "714-531-1189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IGLESIAS",
"first_name": "OSCAR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": "CA",
"license": "101YA0400X",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HOUSE MANAGER",
"identifier": "1001YA0400X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- 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.