Active NPI
Rita K Nijjar, PA-C
- Dermatology Physician
- Costa Mesa, CA
National Provider Identifier
1245306935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- PA17540
- Practice address
- 275 Victoria St
Suite 1H
Costa Mesa, CA 92627-1906 - Phone
- (949) 646-2311
- Fax
- (949) 646-1064
- NPI assigned
- Nov 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | PA17540 | CA | Primary |
Addresses
Primary practice location
275 Victoria St
Suite 1H
Costa Mesa, CA 92627-1906
Mailing address
275 Victoria St
Suite 1H
Costa Mesa, CA 92627-1906
Phone (949) 646-2311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA17540 | Other | CA | PA LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PA17540 | CA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245306935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 VICTORIA ST",
"address_2": "SUITE 1H",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926271906",
"telephone_number": "949-646-2311",
"fax_number": "949-646-1064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 VICTORIA ST",
"address_2": "SUITE 1H",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926271906",
"telephone_number": "949-646-2311",
"fax_number": "949-646-1064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIJJAR",
"first_name": "RITA",
"middle_name": "K",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "PA17540",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA LICENSE",
"identifier": "PA17540",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.