Daniel E. Welburn, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA20234 Issued in CA

Practice address

833 W Whittier Blvd
Montebello, CA 90640-4735

Phone

(323) 712-4811

Fax

(323) 544-6488

NPI assigned

Mar 19, 2009

Last updated

Jun 7, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Credentials

Physician Assistant

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment
• R Ruiz M D a Medical Corp

  dba Rialto Clinica Medica Familiar

  • Primary Care Clinic/Center
  • Rialto, CA
  • NPI 1578599809
  Medicare reassignment
• R Ruiz M D a Professional Corporation

  dba Clinica Medica Familiar y Dental

  • Primary Care Clinic/Center
  • Montebello, CA
  • NPI 1245261023
  Medicare reassignment
• Ruben Ruiz M D a Medical Corporation

  dba Ontario Clinica Medica Familiar

  • Primary Care Clinic/Center
  • Ontario, CA
  • NPI 1043241821
  Medicare reassignment
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510

  Family Medicine

  NPD

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1578704623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 W WHITTIER BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404735",
            "telephone_number": "323-712-4811",
            "fax_number": "323-544-6488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 W WHITTIER BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404735",
            "telephone_number": "323-712-4811",
            "fax_number": "323-544-6488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "436 S Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Rialto",
            "state": "CA",
            "postal_code": "923766523",
            "country_code": "US",
            "telephone_number": "909-877-8868",
            "fax_number": "909-877-0008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "403 W F St",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "CA",
            "postal_code": "917623207",
            "country_code": "US",
            "telephone_number": "909-988-3288",
            "fax_number": "909-988-6767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELBURN",
        "first_name": "DANIEL",
        "middle_name": "E.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-19",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20234",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA20234",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE - REGISTERED NURSE",
            "identifier": "RN527054",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE - PHYSICIAN ASSISTANT",
            "identifier": "PA20234",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victor M Wassily, M.D.
• Richard K Watase, D.D.S.
• Scot K Watase, D.M.D.
• Michael Reeves Weigand, OTR/L
• Zelman Weingarten, MD
• Dylan Wesner, COTA/L
• West Beverly Podiatry Group, Inc.
• Western Dental Services, Inc
• Stanley Wijesekera
• William Hung, M.D., M.P.H. a Medical Corporation

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; 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.