Fidelino Jardiniano Amargo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13145 Issued in CA

Practice address

41880 Kalmia St
Suite 100
Murrieta, CA 92562-8831

Phone

(951) 696-7587

Fax

(951) 461-6973

NPI assigned

Jul 27, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1477867893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41880 KALMIA ST",
            "address_2": "SUITE 100",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925628831",
            "telephone_number": "951-696-7587",
            "fax_number": "951-461-6973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41880 KALMIA ST",
            "address_2": "SUITE 100",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925628831",
            "telephone_number": "951-696-7587",
            "fax_number": "951-461-6973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMARGO",
        "first_name": "FIDELINO",
        "middle_name": "JARDINIANO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-27",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "467220",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.