Individual provider Active NPI

Emmanuel Gonzales Tanay

  • Registered Nurse
  • Santee, CA
National Provider Identifier
1164045217
Registry record updated May 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
659796 Issued in CA
Practice address
655 Park Center Dr
Santee, CA 92071-6957
Phone
(619) 596-6330
NPI assigned
May 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 659796 CA Primary

Addresses

Primary practice location

655 Park Center Dr
Santee, CA 92071-6957

Mailing address

1051 Strawberry Creek St
Chula Vista, CA 91913-2829
Phone (619) 312-7386

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
659796CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1590192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590192000000",
    "number": "1164045217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 STRAWBERRY CREEK ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919132829",
            "telephone_number": "619-312-7386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 PARK CENTER DR",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920716957",
            "telephone_number": "619-596-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAY",
        "first_name": "EMMANUEL",
        "middle_name": "GONZALES",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-23",
        "last_updated": "2020-05-23",
        "certification_date": "2020-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "659796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2020; 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.