Individual provider Active NPI

Joseph Manuel Palacios

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1386533271
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9055 Balboa Ave
San Diego, CA 92123-1509
Phone
(619) 849-7974
NPI assigned
Jul 2, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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 Primary

Addresses

Primary practice location

9055 Balboa Ave
San Diego, CA 92123-1509

Mailing address

PO Box 801721
Santa Clarita, CA 91380-1721
Phone (661) 436-4863

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1386533271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801721",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913801721",
            "telephone_number": "661-436-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9055 BALBOA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231509",
            "telephone_number": "619-849-7974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALACIOS",
        "first_name": "JOSEPH",
        "middle_name": "MANUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-02",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.