Active NPI
Edmund O Pascual, MD
- Pediatrics Physician
- Glendale, CA
National Provider Identifier
1306895412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A42651
- Practice address
- 777 Flower St Ste a
Glendale, CA 91201-3000 - Phone
- (818) 637-2000
- Fax
- (818) 242-8761
- NPI assigned
- May 8, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A42651 | CA | Primary |
Addresses
Primary practice location
777 Flower St Ste a
Glendale, CA 91201-3000
Mailing address
1500 W West Covina Pkwy
Suite 201
West Covina, CA 91790-2703
Phone (626) 263-7020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ32579Z | Other | CA | CHDP |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A42651 | CA | MD | Pediatrics Physician |
Practice roles (3 of 4)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeside Medical Associates, a Medical Group, Inc. | Past | Accepting new patients | |
| Emanate Health Medical Center | Past | Accepting new patients | |
| Emanate Health Medical Center | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- edmund.pascual.p1@direct.lakeside.nextgenshare.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- West Covina, CA
- NPI 1063441293
-
- General Acute Care Hospital
- Covina, CA
- NPI 1982629440
-
- Rheumatology Physician
- Burbank, CA
- NPI 1861499535
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302739200000",
"number": "1306895412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 W WEST COVINA PKWY",
"address_2": "SUITE 201",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917902703",
"telephone_number": "626-263-7020",
"fax_number": "626-960-9177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 FLOWER ST STE A",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912013000",
"telephone_number": "818-637-2000",
"fax_number": "818-242-8761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASCUAL",
"first_name": "EDMUND",
"middle_name": "O",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-08",
"last_updated": "2011-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A42651",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHDP",
"identifier": "ZZZ32579Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.