NPIMap

Individual provider Active NPI

David Ortega-Endahl

  • Physician Assistant
  • Laguna Hills, CA
National Provider Identifier
1336526557
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 52425 Issued in CA
Practice address
23181 Verdugo Dr Ste 103a
Laguna Hills, CA 92653-1313
Phone
(949) 366-1053
NPI assigned
Apr 27, 2015
Last updated
Feb 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 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 PA 52425 CA Primary

Addresses

Primary practice location

23181 Verdugo Dr Ste 103a
Laguna Hills, CA 92653-1313

Mailing address

23181 Verdugo Dr Ste 103a
Laguna Hills, CA 92653-1313
Phone (949) 366-1053

Other practice location 1

15791 Bear Valley Rd Ofc
Hesperia, CA 92345-1746
Phone (760) 949-1231

Other practice location 2

2101 Rosecrans Ave # 3230
El Segundo, CA 90245-4749
Phone (323) 628-8671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150903002697 CA Practitioner - Physician Assistant 1759697840 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
California Wound Healing Medical Group Inc.Group PAC ID 7315033198, 21 clinicians

Practice addresses (Care Compare)

100 E Huntington Dr
Alhambra, CA 91801-1022
Phone (323) 264-7796

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52425CAMDMarriage & Family Therapist
PA 52425CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tyson Medical Inc CurrentSince Mar 31, 2022 Accepting new patients
Healing Edge Medical Group - Ca CurrentSince Dec 9, 2025 Accepting new patients
Prisma Care, a Medical Corporation PastSince Jun 11, 2002 Accepting new patients
New Hope Podiatry Group Inc. PastSince Dec 29, 2024 Accepting new patients
Amistad Multi Specialty Medical Group Inc. Past Accepting new patients
Maroon-Lopez DDS, PC Past Accepting new patients
Omni Family Health Past Accepting new patients

Locations

100 E Huntington Dr
Ste 203
Alhambra, CA 91801

207 W Legion Rd
Brawley, CA 92227
Phone (760) 351-3333

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dortegaendahl32485@sharphealthcare.direct-ci.com
  • Direct secure messaging: dortegaendahl@landmarkhealth-direct.org

Organizations & group practices 11

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": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1336526557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23181 VERDUGO DR STE 103A",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531313",
            "telephone_number": "949-366-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23181 VERDUGO DR STE 103A",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531313",
            "telephone_number": "949-366-1053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15791 Bear Valley Rd Ofc",
            "address_purpose": "LOCATION",
            "city": "Hesperia",
            "state": "CA",
            "postal_code": "923451746",
            "country_code": "US",
            "telephone_number": "760-949-1231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2101 Rosecrans Ave # 3230",
            "address_purpose": "LOCATION",
            "city": "El Segundo",
            "state": "CA",
            "postal_code": "902454749",
            "country_code": "US",
            "telephone_number": "323-628-8671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORTEGA-ENDAHL",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-27",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 52425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.