Individual provider Active NPI

Antonio Perez Morales, PHYSICIAN ASSISTANT/

  • Physician Assistant
  • Pomona, CA
National Provider Identifier
1316679780
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
309 E 2ND St
Pomona, CA 91766-1854
Phone
(562) 484-4244
NPI assigned
Jun 25, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

309 E 2ND St
Pomona, CA 91766-1854

Mailing address

309 E 2ND St
Pomona, CA 91766-1854
Phone (562) 484-4244

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
I20240213002728 CA Practitioner - Physician Assistant 4082057450 Reassigns benefits to 1 organization

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1656115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1316679780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E 2ND ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661854",
            "telephone_number": "562-484-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E 2ND ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661854",
            "telephone_number": "562-484-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "ANTONIO",
        "middle_name": "PEREZ",
        "credential": "PHYSICIAN ASSISTANT/",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-25",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.