Active NPI
John Diab, PA
- Physician Assistant
- Orange, CA
National Provider Identifier
1164687570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA53252
- Practice address
- 867 S Tustin St
Orange, CA 92866-3426 - Phone
- (714) 771-1420
- Fax
- (714) 771-6918
- NPI assigned
- Jul 24, 2008
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA53252 | CA | Primary |
Addresses
Primary practice location
867 S Tustin St
Orange, CA 92866-3426
Mailing address
867 S Tustin St
Orange, CA 92866-3426
Phone (714) 771-1420
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011783-1 | NY | MD | Occupational Therapist |
| PA53252 | CA | MD | Physician Assistant |
Interoperability endpoints
- john.diab@3856.securemail.prognocis.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460073600000",
"number": "1164687570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "867 S TUSTIN ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928663426",
"telephone_number": "714-771-1420",
"fax_number": "714-771-6918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "867 S TUSTIN ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928663426",
"telephone_number": "714-771-1420",
"fax_number": "714-771-6918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAB",
"first_name": "JOHN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-24",
"last_updated": "2016-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA53252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.