Individual provider Active NPI

Imelda Meili Hau, FNP-BC

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1407090905
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20196 Issued in CA
Practice address
7930 Frost St Ste 104
San Diego, CA 92123-4294
Phone
(858) 277-0696
NPI assigned
Apr 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 20196 CA Primary
Family Nurse Practitioner 363LF0000X RN247219 GA

Addresses

Primary practice location

7930 Frost St Ste 104
San Diego, CA 92123-4294

Mailing address

7930 Frost St Ste 104
San Diego, CA 92123-4294

Other practice location 1

3637 Peachtree Rd NE
Atlanta, GA 30319-1252
Phone (866) 389-2727

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
I20140903001643 CA Practitioner - Nurse Practitioner 7517019839 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1173HIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Centers Inc CurrentSince Aug 21, 2017 Accepting new patients
Community Medical Centers, Inc. CurrentSince Aug 21, 2017 Accepting new patients
Minuteclinic Diagnostic Medical Group of California Inc Family CurrentSince Sep 15, 2014 Accepting new patients
Community Medical Centers, Inc. Current Accepting new patients
Sharp Healthcare PastSince Apr 15, 2018 Accepting new patients

Locations

1401 S Baldwin Ave
Arcadia, CA 91007
Phone (626) 321-4210

1350 Florin Rd
Sacramento, CA 95822
Phone (916) 392-5184

2455 San Ramon Valley Blvd
San Ramon, CA 94583
Phone (925) 820-7325

7210 Murray Dr
Stockton, CA 95210
Phone (209) 373-2816

730 N Central Ave
Tracy, CA 95376
Phone (209) 820-1500

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1407090905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7930 FROST ST STE 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7930 FROST ST STE 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234294",
            "telephone_number": "858-277-0696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3637 Peachtree Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303191252",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAU",
        "first_name": "IMELDA",
        "middle_name": "MEILI",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "20196",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN247219",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.