Active NPI
Jose Angel Zavala
- Physician Assistant
- Costa Mesa, CA
National Provider Identifier
1306938873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA12848
- Practice address
- 700 W 19TH St
Costa Mesa, CA 92627-3517 - Phone
- (949) 645-9334
- NPI assigned
- Sep 29, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA12848 | CA | Primary |
Addresses
Primary practice location
700 W 19TH St
Costa Mesa, CA 92627-3517
Mailing address
700 W 19TH St
Costa Mesa, CA 92627-3517
Phone (949) 645-9334
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 |
|---|---|---|---|
| PA12848 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306938873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 W 19TH ST",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926273517",
"telephone_number": "949-645-9334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 W 19TH ST",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926273517",
"telephone_number": "949-645-9334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAVALA",
"first_name": "JOSE",
"middle_name": "ANGEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA12848",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.