Active NPI
Pablo Ivan Vargas, NP
- Nurse Practitioner
- Loma Linda, CA
National Provider Identifier
1356613301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 21413
- Practice address
- 11234 Anderson St
Loma Linda, CA 92354-2804 - Phone
- (909) 558-4344
- NPI assigned
- Feb 7, 2012
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 21413 | CA | Primary |
Addresses
Primary practice location
11234 Anderson St
Loma Linda, CA 92354-2804
Mailing address
File # 54701
Los Angeles, CA 90074-4701
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21413 | CA | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Physicians' Hospital of Murrieta, LLC | Past | Accepting new patients | |
| Loma Linda University Medical Center | Past | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Past | Accepting new patients |
Locations
11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016
11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
File 54701
Los Angeles, CA 90074
Phone (909) 651-4300
Organizations & group practices 8
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.
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- General Acute Care Hospital
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328572800000",
"number": "1356613301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FILE # 54701",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900744701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923542804",
"telephone_number": "909-558-4344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARGAS",
"first_name": "PABLO",
"middle_name": "IVAN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-07",
"last_updated": "2012-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "21413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.