Individual provider Active NPI

Jonathan Blic Arpon Masayon, LVN

  • Licensed Vocational Nurse
  • Pomona, CA
National Provider Identifier
1124395116
Registry record updated Nov 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN242379 Issued in CA
Practice address
2018 Las Vegas Ave Apt 9
Pomona, CA 91767-2735
Phone
(626) 274-1431
NPI assigned
Nov 19, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN242379 CA Primary

Addresses

Primary practice location

2018 Las Vegas Ave Apt 9
Pomona, CA 91767-2735

Mailing address

2018 Las Vegas Ave. Apt. 9
Pomona, CA 91767-2139
Phone (626) 274-1431

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

LicenseStateTypeSpecialty
VN242379CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1321660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321660800000",
    "number": "1124395116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 LAS VEGAS AVE. APT. 9",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672139",
            "telephone_number": "626-274-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 LAS VEGAS AVE APT 9",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672735",
            "telephone_number": "626-274-1431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASAYON",
        "first_name": "JONATHAN BLIC",
        "middle_name": "ARPON",
        "name_prefix": "Mr.",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-19",
        "last_updated": "2011-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN242379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; 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.