Individual provider Active NPI

Emilio Chan Edquilang Jr.

  • Medical Technologist
  • San Diego, CA
National Provider Identifier
1306014758
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical TechnologistTaxonomy code 246QM0706X
License
MTA35936 Issued in CA
Practice address
34425 Farenholt Avenue
Suite 40, BLDG. 26-2B
San Diego, CA 92134-7040
Phone
(619) 532-7141
Fax
(619) 532-7337
NPI assigned
Feb 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Technologist 246QM0706X MTA35936 CA Primary

Addresses

Primary practice location

34425 Farenholt Avenue
Suite 40, BLDG. 26-2B
San Diego, CA 92134-7040

Mailing address

34425 Farenholt Avenue
Suite 40, BLDG. 26-2B
San Diego, CA 92134-7040
Phone (619) 532-7141

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

LicenseStateTypeSpecialty
MTA35936CAMDMedical Technologist

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1306014758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34425 FARENHOLT AVENUE",
            "address_2": "SUITE 40, BLDG. 26-2B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921347040",
            "telephone_number": "619-532-7141",
            "fax_number": "619-532-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34425 FARENHOLT AVENUE",
            "address_2": "SUITE 40, BLDG. 26-2B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921347040",
            "telephone_number": "619-532-7141",
            "fax_number": "619-532-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDQUILANG",
        "first_name": "EMILIO",
        "middle_name": "CHAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": "CA",
            "license": "MTA35936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.