Active NPI
Edelson Flores, OTR/L
- Occupational Therapist
- National City, CA
National Provider Identifier
1124685656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 17609
- Practice address
- 220 E 24TH St
National City, CA 91950-6705 - Phone
- (619) 474-6741
- NPI assigned
- May 20, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 17609 | CA | Primary |
Addresses
Primary practice location
220 E 24TH St
National City, CA 91950-6705
Mailing address
13558 Moorpark St Apt 6
Sherman Oaks, CA 91423-6166
Phone (516) 469-8879
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558310400000",
"number": "1124685656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13558 MOORPARK ST APT 6",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914236166",
"telephone_number": "516-469-8879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 E 24TH ST",
"city": "NATIONAL CITY",
"state": "CA",
"postal_code": "919506705",
"telephone_number": "619-474-6741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLORES",
"first_name": "EDELSON",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-20",
"last_updated": "2019-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "17609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in National City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.