Individual provider Active NPI

Jorge Edward Delgado

  • Non-emergency Medical Transport (VAN)
  • Long Beach, CA
National Provider Identifier
1215425129
Registry record updated Apr 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
TCP0036165P Issued in CA
Practice address
610 Coronado Ave
Long Beach, CA 90814-1438
Phone
(562) 856-5458
NPI assigned
Apr 26, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X TCP0036165P CA Primary

Addresses

Primary practice location

610 Coronado Ave
Long Beach, CA 90814-1438

Mailing address

PO Box 3743
Long Beach, CA 90803-0743
Phone (562) 856-5458

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
TCP0036165PCAMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1215425129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3743",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908030743",
            "telephone_number": "562-856-5458",
            "fax_number": "562-856-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 CORONADO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908141438",
            "telephone_number": "562-856-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADO",
        "first_name": "JORGE",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-26",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CA",
            "license": "TCP0036165P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; 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.