Individual provider Active NPI

Jose A Del Real, LAC

  • Acupuncturist
  • Chula Vista, CA
National Provider Identifier
1487164323
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
17795 Issued in CA
Practice address
1229 3Rd Ave Ste C
Chula Vista, CA 91911-3212
Phone
(619) 271-2772
NPI assigned
Oct 5, 2017
Last updated
Oct 5, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 17795 CA Primary

Addresses

Primary practice location

1229 3Rd Ave Ste C
Chula Vista, CA 91911-3212

Mailing address

641 E San Ysidro Blvd # B3-525
San Ysidro, CA 92173-3129
Phone (619) 253-3105

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

State licenses

LicenseStateTypeSpecialty
17795CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CT Global LLC Acupuncturist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507161600000",
    "number": "1487164323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 E SAN YSIDRO BLVD # B3-525",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921733129",
            "telephone_number": "619-253-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 3RD AVE STE C",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919113212",
            "telephone_number": "619-271-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL REAL",
        "first_name": "JOSE",
        "middle_name": "A",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-05",
        "last_updated": "2017-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "17795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; 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.