Individual provider Active NPI

Celso Villanueva Cayanan

  • Independent Duty Corpsman
  • San Diego, CA
National Provider Identifier
1205174752
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
License
00000000000000000000 Issued in CA
Practice address
2051 Cushing Rd
San Diego, CA 92106-6173
Phone
(619) 524-5733
NPI assigned
Jan 17, 2013
Last updated
Jan 17, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X 00000000000000000000 CA Primary

Addresses

Primary practice location

2051 Cushing Rd
San Diego, CA 92106-6173

Mailing address

2051 Cushing Road
Fpo, AP 92106
Phone (619) 524-5733

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
00000000000000000000CAMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1205174752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "2051 CUSHING ROAD",
            "city": "FPO",
            "state": "AP",
            "postal_code": "92106",
            "telephone_number": "619-524-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 CUSHING RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066173",
            "telephone_number": "619-524-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAYANAN",
        "first_name": "CELSO",
        "middle_name": "VILLANUEVA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-17",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "CA",
            "license": "00000000000000000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; 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.