Cecilia Cudiamat, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA16619 Issued in CA

Practice address

711 E Rosecrans Ave
East Rancho Dominguez, CA 90221-2143

Phone

(310) 635-5223

Fax

(310) 635-2846

NPI assigned

Mar 12, 2008

Sex

Female

Sole proprietor

Yes

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Prohealth Partners, a Medical Group

  • Internal Medicine Physician
  • Lakewood, CA
  • NPI 1003949975
  Medicare reassignment
• Prohealth Partners, a Medical Group, Inc.

  • Internal Medicine Physician
  • Pico Rivera, CA
  • NPI 1912899394
  NPD

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1124299623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 E ROSECRANS AVE",
            "city": "EAST RANCHO DOMINGUEZ",
            "state": "CA",
            "postal_code": "902212143",
            "telephone_number": "310-635-5223",
            "fax_number": "310-635-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E ROSECRANS AVE",
            "city": "EAST RANCHO DOMINGUEZ",
            "state": "CA",
            "postal_code": "902212143",
            "telephone_number": "310-635-5223",
            "fax_number": "310-635-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUDIAMAT",
        "first_name": "CECILIA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-12",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA16619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Barthel
• Yvonne Renee Battiste, RN
• Margaux Bonzon
• Kimberly Brown
• Joseemar Coreas
• Daniel Matemotja, MD Inc
• Jayden Davila, BSN, RN
• Leslie Guadalupe De la Cruz-Trejo
• De Novo Health Care Inc
• Angelica Delallana, MSN, APRN, FNP

• Medical Physician Assistant in East Rancho Dominguez, CA
• Providers in East Rancho Dominguez, 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 Mar 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.