Active NPI
Victor H Robles, P.A.
- Physician Assistant
- Garden Grove, CA
National Provider Identifier
1457368227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 17743
- Practice address
- 12555 Garden Grove Blvd
Suite 206
Garden Grove, CA 92843-1902 - Phone
- (714) 537-6595
- NPI assigned
- Aug 2, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 17743 | CA | Primary |
Addresses
Primary practice location
12555 Garden Grove Blvd
Suite 206
Garden Grove, CA 92843-1902
Mailing address
12555 Garden Grove Blvd
Suite 206
Garden Grove, CA 92843-1902
Phone (714) 537-6595
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19775 | Other | CA | RESPIRATORY CARE PROVIDER |
| PA 17743 | Other | CA | CALIFORNIA LICENSE |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 17743 | CA | MD | Physician Assistant |
| 17743 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - California | Current | Accepting new patients |
Locations
2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457368227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12555 GARDEN GROVE BLVD",
"address_2": "SUITE 206",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928431902",
"telephone_number": "714-537-6595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12555 GARDEN GROVE BLVD",
"address_2": "SUITE 206",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928431902",
"telephone_number": "714-537-6595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBLES",
"first_name": "VICTOR",
"middle_name": "H",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA 17743",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RESPIRATORY CARE PROVIDER",
"identifier": "19775",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA LICENSE",
"identifier": "PA 17743",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.