Active NPI
Alvaro Prieto, PA
- Physician Assistant
- Gardena, CA
National Provider Identifier
1356499297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA10312
- Practice address
- 1149 W 190TH St
Suite 2300
Gardena, CA 90248-4321 - Phone
- (310) 324-3068
- NPI assigned
- Jan 8, 2007
- 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 | PA10312 | CA | Primary |
Addresses
Primary practice location
1149 W 190TH St
Suite 2300
Gardena, CA 90248-4321
Mailing address
808 E Desford St
Carson, CA 90745-2234
Phone (310) 922-7112
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10312 | CA | MD | Acupuncturist |
| PA10312 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431216000000",
"number": "1356499297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 E DESFORD ST",
"city": "CARSON",
"state": "CA",
"postal_code": "907452234",
"telephone_number": "310-922-7112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1149 W 190TH ST",
"address_2": "SUITE 2300",
"city": "GARDENA",
"state": "CA",
"postal_code": "902484321",
"telephone_number": "310-324-3068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIETO",
"first_name": "ALVARO",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2015-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA10312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.