Individual provider Active NPI

Itzel Monserrat Vazquez Vazquez, M.D

  • Student in an Organized Health Care Education/Training Program
  • South Gate, CA
National Provider Identifier
1215559083
Registry record updated May 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
8625 Atlantic Ave
South Gate, CA 90280
Phone
(323) 312-2605
NPI assigned
May 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

8625 Atlantic Ave
South Gate, CA 90280

Mailing address

8625 Atlantic Ave
South Gate, CA 90280
Phone (323) 312-2605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231018000475 CA Order and Referring Only - Family PracticePractitioner - Family Practice 8820443328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: itzel.vasquez.vasquez.1@17661.direct.athenahealth.com
  • Direct secure messaging: itzel.vazquez.vazquez.1@31788.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653091200000",
    "number": "1215559083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8625 ATLANTIC AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "90280",
            "telephone_number": "323-312-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8625 ATLANTIC AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "90280",
            "telephone_number": "323-312-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ VAZQUEZ",
        "first_name": "ITZEL",
        "middle_name": "MONSERRAT",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-14",
        "last_updated": "2022-05-21",
        "certification_date": "2022-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Gate, CA

Sources for this page

Verify at the official NPI Registry.