Individual provider Active NPI

Efrain Torres Valladolid, M.D.

  • Family Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1407051782
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A61474 Issued in CA
Practice address
584 E St
Chula Vista, CA 91910-2348
Phone
(619) 420-1378
Fax
(619) 420-1331
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A61474 CA Primary

Addresses

Primary practice location

584 E St
Chula Vista, CA 91910-2348

Mailing address

584 E St
Chula Vista, CA 91910-2348
Phone (619) 420-1378

Other identifiers 1

IdentifierTypeStateIssuer
00A614740MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110429000617 CA Practitioner - Family Practice 9436186012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Diego School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

584 E St
Chula Vista, CA 91910-2348
Phone (619) 420-1378

Hospital & facility affiliations

  • Archer Health Inc Home health agency, Carlsbad, CA, CCN 053124
  • Sharp Chula Vista Medical Center Hospital, Chula Vista, CA, CCN 050222
  • Sharp Coronado Hospital and Hlthcr Ctr Hospital, Coronado, CA, CCN 050234
  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100
  • Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A61474CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Bay Family Medical Group, Inc Family Medicine CurrentSince Jun 1, 2002 Accepting new patients
Sharp Chula Vista Medical Center Past Accepting new patients

Locations

584 E St
Ste 18
Chula Vista, CA 91910
Phone (619) 420-1378

584 E St
Chula Vista, CA 91910
Phone (619) 409-9000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: evalladolid32406@sharphealthcare.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/13156/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1407051782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "584 E ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102348",
            "telephone_number": "619-420-1378",
            "fax_number": "619-420-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 E ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102348",
            "telephone_number": "619-420-1378",
            "fax_number": "619-420-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLADOLID",
        "first_name": "EFRAIN",
        "middle_name": "TORRES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A61474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A614740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.