Individual provider Active NPI

Araceli M Elizondo, P.A.

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1356541031
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PENDING
Practice address
1850 Del Paso Ave
Los Angeles, CA 90032-3836
Phone
(323) 227-9660
NPI assigned
Jul 20, 2007
Last updated
Jul 20, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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 PENDING Primary

Addresses

Primary practice location

1850 Del Paso Ave
Los Angeles, CA 90032-3836

Mailing address

1401 S Grand Ave
Los Angeles, CA 90015-3010
Phone (213) 748-2411

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
I20080602000910 CA Practitioner - Physician Assistant 2466522412 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19290CAMDSpeech-Language Pathologist

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, 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": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1356541031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S GRAND AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153010",
            "telephone_number": "213-748-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 DEL PASO AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900323836",
            "telephone_number": "323-227-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZONDO",
        "first_name": "ARACELI",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.