Active NPI
Abigail Vidikan, LM CPM
- Midwife
- Irvine, CA
National Provider Identifier
1275064321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 486
- Practice address
- 3 Bascom St
Irvine, CA 92612-2128 - Phone
- (310) 801-5184
- Fax
- (310) 564-2305
- NPI assigned
- Mar 21, 2017
- 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 |
|---|---|---|---|---|
| Midwife | 176B00000X | 486 | CA | Primary |
Addresses
Primary practice location
3 Bascom St
Irvine, CA 92612-2128
Mailing address
3 Bascom St
Irvine, CA 92612-2128
Phone (310) 801-5184
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 |
|---|---|---|---|
| 486 | CA | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490054400000",
"number": "1275064321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 BASCOM ST",
"city": "IRVINE",
"state": "CA",
"postal_code": "926122128",
"telephone_number": "310-801-5184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 BASCOM ST",
"city": "IRVINE",
"state": "CA",
"postal_code": "926122128",
"telephone_number": "310-801-5184",
"fax_number": "310-564-2305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDIKAN",
"first_name": "ABIGAIL",
"name_prefix": "Mrs.",
"credential": "LM CPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-21",
"last_updated": "2017-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CA",
"license": "486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.