Individual provider Active NPI

Caleb Dizon, FNP-C

  • Nurse Practitioner
  • Whittier, CA
National Provider Identifier
1518473552
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95008167 Issued in CA
Practice address
9080 Colima Rd
Whittier, CA 90605-1600
Phone
(562) 945-3561
NPI assigned
Dec 27, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP95008167 CA Primary

Addresses

Primary practice location

9080 Colima Rd
Whittier, CA 90605-1600

Mailing address

260 E Holt Ave
Pomona, CA 91767-5426

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20180406001133 CA Practitioner - Nurse Practitioner 2860755717 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12100 Euclid St
Garden Grove, CA 92840-3304
Phone (888) 988-2800

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95008167CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince Sep 17, 2020 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Providence Facey Medical Foundation Current Accepting new patients
Providence Facey Medical Foundation CurrentSince Sep 17, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 19, 2021 Accepting new patients
East Valley Emergency Medical Associates, Inc CurrentSince Mar 9, 2018 Accepting new patients
Gem Medical Group Corporation CurrentSince May 1, 2023 Accepting new patients
Gem Medical Group Corporation CurrentSince May 1, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 19, 2021 Accepting new patients
Golden West Emergency Medical Associates, Inc CurrentSince May 1, 2020 Accepting new patients

Locations (25 of 26)

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

26777 Agoura Rd
Ste 4
Calabasas, CA 91302
Phone (818) 880-2225

359 Carmen Dr
Camarillo, CA 93010
Phone (805) 914-5592

475 Foothill Blvd
Ste K
La Canada, CA 91011
Phone (818) 528-6377

475 Foothill Blvd
La Canada, CA 91011
Phone (818) 528-6377

8000 W Sunset Blvd
Ste C110
Los Angeles, CA 90046
Phone (213) 412-0400

2090 Westwood Blvd
Los Angeles, CA 90025
Phone (213) 813-4070

8985 Venice Blvd
Los Angeles, CA 90034
Phone (310) 474-2152

3215 N Sepulveda Blvd
Manhattan Beach, CA 90266
Phone (424) 295-0540

4730 Lincoln Blvd
Marina del Rey, CA 90292
Phone (424) 352-0371

525 N Garfield Ave
Monterey Park, CA 91754
Phone (626) 573-2222

900 S Atlantic Blvd
Monterey Park, CA 91754
Phone (626) 457-7450

19346 Nordhoff St
Northridge, CA 91324
Phone (818) 727-2024

3160 E Del Mar Blvd
Ste 110
Pasadena, CA 91107
Phone (626) 270-2400

6020 Seabluff Dr
Ste 1
Playa Vista, CA 90094
Phone (310) 862-0400

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

725 S Pacific Coast Hwy
Redondo Beach, CA 90277
Phone (424) 296-3100

395 Silver Spur Rd
Rolling Hills Estates, CA 90274
Phone (424) 323-3500

14550 Soledad Canyon Rd
#100
Santa Clarita, CA 91387
Phone (661) 488-7402

13303 Riverside Dr
Sherman Oaks, CA 91423
Phone (818) 287-7409

25548 The Old Rd
Unit 1
Stevenson Ranch, CA 91381

701 N Wendy Dr
Thousand Oaks, CA 91320
Phone (805) 375-4400

6440 Platt Ave
West Hills, CA 91307
Phone (818) 946-1103

111 S Westlake Blvd
Ste 110
Westlake Village, CA 91362
Phone (805) 557-8177

Organizations & group practices 10

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": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1518473552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 E HOLT AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9080 COLIMA RD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906051600",
            "telephone_number": "562-945-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIZON",
        "first_name": "CALEB",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-27",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95008167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.