Pure Pulse Health Physician Assistant, Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PURE PULSE HEALTH PHYSICIAN ASSISTANT, INC

Practice address

802 Magnolia Ave Ste 102
Corona, CA 92879-3124

Phone

(714) 455-9831

NPI assigned

Feb 2, 2024

Last updated

Feb 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Dipali P Radia, PA-CNPI 1437812260

Title

Ceo

Phone

(714) 553-5100

Specialties & licenses 3

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dipali Patel Radia, PA

  • Physician Assistant
  • Riverside, CA
  • NPI 1437812260
  NPD Authorized official

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1154184018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 MAGNOLIA AVE STE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793124",
            "telephone_number": "714-455-9831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 MAGNOLIA AVE STE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793124",
            "telephone_number": "714-455-9831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE PULSE HEALTH PHYSICIAN ASSISTANT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "RADIA",
        "authorized_official_first_name": "DIPALI",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-553-5100",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437812260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Corona, CA
• Providers in Corona, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.