Eric Ricardo De la Vega, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17158 Issued in CA

Practice address

1006 W la Palma Ave
Anaheim, CA 92801-3650

Phone

(714) 778-3838

Fax

(714) 778-1962

NPI assigned

Oct 13, 2006

Last updated

Jun 24, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1255421921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N EUCLID ST STE 400",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928014122",
            "telephone_number": "714-517-2100",
            "fax_number": "714-300-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 W LA PALMA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928013650",
            "telephone_number": "714-778-3838",
            "fax_number": "714-778-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA VEGA",
        "first_name": "ERIC",
        "middle_name": "RICARDO",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paulina De la Mora, BA
• Maribel De la O
• De la Paz Medical Centre Inc
• Hailey De la Roca, NURSE PRACTITIONER
• Claudia De la Torre
• Steven De Lara
• Loyda De Leon Calderon
• Zoe De Leon-Ortega
• Brenda De Leon
• Cindy De Leon

• Physician Assistant in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.