Organization Active NPI

Ignacio Valdes MD a Professional

  • Obstetrics & Gynecology Physician
  • Glendale, CA
National Provider Identifier
1487926663
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G62465 Issued in CA
Legal business name
IGNACIO VALDES MD A PROFESSIONAL
Practice address
222 W Eulalia St
Suite 211
Glendale, CA 91204-2851
Phone
(818) 502-4567
Fax
(818) 502-4569
NPI assigned
Feb 2, 2012
Last updated
Sep 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Authorized official

Name
Ignacio Valdes, M.D.NPI 1265534580
Title
Owner
Phone
(818) 502-4567

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G62465 CA Primary

Addresses

Primary practice location

222 W Eulalia St
Suite 211
Glendale, CA 91204-2851

Mailing address

222 W Eulalia St
Suite 211
Glendale, CA 91204-2851
Phone (818) 502-4567

Other identifiers 1

IdentifierTypeStateIssuer
00G624650MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120607000626 CA Part B Supplier - Clinic/Group Practice 4688838444 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1487926663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W EULALIA ST",
            "address_2": "SUITE 211",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042851",
            "telephone_number": "818-502-4567",
            "fax_number": "818-502-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W EULALIA ST",
            "address_2": "SUITE 211",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042851",
            "telephone_number": "818-502-4567",
            "fax_number": "818-502-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNACIO VALDES MD A PROFESSIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-02",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "VALDES",
        "authorized_official_first_name": "IGNACIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-502-4567",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G62465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G624650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.