Individual provider Active NPI

Ernesto E. Magdaleno, P.A.

  • Medical Physician Assistant
  • Pico Rivera, CA
National Provider Identifier
1285921700
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA20960 Issued in CA
Practice address
8610 Whittier Blvd
Pico Rivera, CA 90660-2655
Phone
(562) 354-5847
NPI assigned
Jul 5, 2011
Last updated
Aug 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA20960 CA Primary

Addresses

Primary practice location

8610 Whittier Blvd
Pico Rivera, CA 90660-2655

Mailing address

8610 Whittier Blvd
Pico Rivera, CA 90660-2655
Phone (562) 354-5847

Other practice location 1

9201 Whittier Blvd
Pico Rivera, CA 90660-2450
Phone (562) 692-0400

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120904000440 CA Practitioner - Physician Assistant 5294982849 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
20960CAMDAddiction (Substance Use Disorder) Counselor
PA20960CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cure4Feet Podiatry Group Inc PastSince Oct 15, 2013 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1285921700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8610 WHITTIER BLVD",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602655",
            "telephone_number": "562-354-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8610 WHITTIER BLVD",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602655",
            "telephone_number": "562-354-5847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9201 Whittier Blvd",
            "address_purpose": "LOCATION",
            "city": "Pico Rivera",
            "state": "CA",
            "postal_code": "906602450",
            "country_code": "US",
            "telephone_number": "562-692-0400",
            "fax_number": "562-205-1555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGDALENO",
        "first_name": "ERNESTO",
        "middle_name": "E.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-05",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pico Rivera, CA

Sources for this page

Verify at the official NPI Registry.