Susan L Vasquez, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17686 Issued in CA

Practice address

1568 N Orange Grove Ave
Pomona, CA 91767-3812

Phone

(909) 868-6666

NPI assigned

Jun 4, 2008

Last updated

Oct 13, 2010By the provider in NPPES

Sex

Female

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Central City Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1235283094
  Medicare reassignment
• Central City Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • El Monte, CA
  • NPI 1972912236
  NPD
• Pomona Valley Community Health Center

  • Community Health Clinic/Center
  • Pomona, CA
  • NPI 1043565096
  NPD (past)
• Ricardo Di Sarli MD a Medical Corporation

  dba Pomona Mission Medical Clinic

  • Family Medicine Physician
  • Pomona, CA
  • NPI 1285739979
  NPD (past)

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1548429699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917230307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1568 N ORANGE GROVE AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673812",
            "telephone_number": "909-868-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-04",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17686",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "1063898",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tenny Vasghanian
• Abraham Vasquez
• Carlos Vasquez
• Marissa Katrina Vasquez
• Priscilla Jeaneth Vasquez, CCAPP
• Abigail Vazquez
• Aidan Cesar Vazquez
• Jazilynn Jaylene Vazquez
• Lynette Guadalupe Vazquez
• Vanessa Iliana Vazquez

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; 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.

Verify at the official NPI Registry.