Pablo De Jesus Cruz Landa

Primary specialty

DriverTaxonomy code 172A00000X

License

A7604227 Issued in CA

Practice address

13876 Harbor Blvd Ste 3B
Garden Grove, CA 92843-4029

Phone

(714) 909-5817

NPI assigned

Jul 4, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Cheri'S Cafe

  • Non-emergency Medical Transport (VAN)
  • Garden Grove, CA
  • NPI 1235841669
  NPD Authorized official

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

{
    "created_epoch": "1656892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656892800000",
    "number": "1386377729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 MABURY ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927057149",
            "telephone_number": "714-909-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13876 HARBOR BLVD STE 3B",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434029",
            "telephone_number": "714-909-5817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ LANDA",
        "first_name": "PABLO",
        "middle_name": "DE JESUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-04",
        "last_updated": "2022-07-04",
        "certification_date": "2022-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "CA",
            "license": "A7604227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Olson Crisostomo, BCBA
• Noah Joseph Crisp
• Grecia Crispin
• Joseph Crosthwait
• Paige Crumley
• Alondra Cruz
• Esmeralda Cruz
• Kevin Cruz
• Kimberly Lynn Cruz, RDHAP
• Maria Isabel Cruz

• Driver in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Driver in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.