Active NPI
Katy Dibene
- Medical Physician Assistant
- El Segundo, CA
National Provider Identifier
1578052916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 2101 Rosecrans Ave # 3230
El Segundo, CA 90245-4749 - Phone
- (323) 628-8671
- NPI assigned
- May 1, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Primary |
Addresses
Primary practice location
2101 Rosecrans Ave # 3230
El Segundo, CA 90245-4749
Mailing address
309 E 2ND St
Pomona, CA 91766-1854
Other practice location 1
309 E 2nd St
Pomona, CA 91766-1854
Phone (909) 623-6116
Other practice location 2
2430 Cardinal Dr Apt 25
San Diego, CA 92123-4128
Phone (714) 356-4789
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)
- Enrolled
Interoperability endpoints
- kswartzbaugh@landmarkhealth-direct.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698624000000",
"number": "1578052916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 E 2ND ST",
"city": "POMONA",
"state": "CA",
"postal_code": "917661854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 ROSECRANS AVE # 3230",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902454749",
"telephone_number": "323-628-8671"
}
],
"practiceLocations": [
{
"address_1": "309 E 2nd St",
"address_purpose": "LOCATION",
"city": "Pomona",
"state": "CA",
"postal_code": "917661854",
"country_code": "US",
"telephone_number": "909-623-6116",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2430 Cardinal Dr Apt 25",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921234128",
"country_code": "US",
"telephone_number": "714-356-4789",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIBENE",
"first_name": "KATY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-01",
"last_updated": "2023-10-30",
"certification_date": "2023-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Segundo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.