Ibarra Gambota Diangkinay, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

95004040 Issued in CA

Practice address

850 E Latham Ave Ste 201
Hemet, CA 92543-4391

Phone

(951) 925-6657

NPI assigned

Apr 11, 2016

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1154785673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 E LATHAM AVE STE 201",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434391",
            "telephone_number": "951-925-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E LATHAM AVE STE 201",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434391",
            "telephone_number": "951-925-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIANGKINAY",
        "first_name": "IBARRA",
        "middle_name": "GAMBOTA",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95004040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yurzul N Dhanani, MD
• Raghav Dhawan, MD
• DHHS IHS Cao Desert Sage Youth Wellness Center
• Darshan Kumar Dhiman, M.D.
• Emily Maragaret Di Yorio
• Anarella Carmen Diaz, FNP-C
• Crystal Diaz, FNP
• Irma Judith Diaz
• Raymond Diaz
• Lawrence Dicapua, M.D.

• Adult Health Nurse Practitioner in Hemet, CA
• Providers in Hemet, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.