Individual provider Active NPI

Rolly Abutal Comia, BSN RN

  • Emergency Registered Nurse
  • Fresno, CA
National Provider Identifier
1265041966
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
694553 Issued in CA
Practice address
6963 E Michigan Ave
Fresno, CA 93727-1443
Phone
(559) 375-1658
NPI assigned
Jul 28, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WE0003X 694553 CA Primary

Addresses

Primary practice location

6963 E Michigan Ave
Fresno, CA 93727-1443

Mailing address

6963 E Michigan Ave
Fresno, CA 93727-1443
Phone (559) 375-1658

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
694553CAMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1265041966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6963 E MICHIGAN AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937271443",
            "telephone_number": "559-375-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6963 E MICHIGAN AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937271443",
            "telephone_number": "559-375-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMIA",
        "first_name": "ROLLY",
        "middle_name": "ABUTAL",
        "credential": "BSN RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Emergency",
            "state": "CA",
            "license": "694553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.