Individual provider Active NPI

Alan A Valenzuela, PA-C

  • Physician Assistant
  • Banning, CA
National Provider Identifier
1598048407
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21810 Issued in CA
Practice address
264 N Highland Springs Ave Ste 4
Banning, CA 92220-3082
Phone
(951) 769-0079
Fax
(888) 854-7592
NPI assigned
Sep 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA21810 CA Primary

Addresses

Primary practice location

264 N Highland Springs Ave Ste 4
Banning, CA 92220-3082

Mailing address

264 N Highland Springs Ave # 4
Banning, CA 92220-3082
Phone (951) 769-0079

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
I20120424000496 CA Practitioner - Physician Assistant 0345402186 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

7000 Boulder Ave
Suite 103
Highland, CA 92346-3348
Phone (515) 441-6271

839 Highland Springs Ave
Suite 101
Beaumont, CA 92223-5767
Phone (951) 521-1580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Urgent Care #3, Inc. CurrentSince May 8, 2019 Accepting new patients
Cep America-California CurrentSince Sep 17, 2012 Accepting new patients
Premier Emergency Physicians of California Medical Group PC Physician Assistant Past Accepting new patients
Rainbow Basin Emergency Physicians, a Medical Corporation Physician Assistant Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

78965 Highway 111
Ste 100
La Quinta, CA 92253
Phone (706) 777-7847

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

Interoperability endpoints

  • Direct secure messaging: alan.valenzuela.p1@direct.altura.nextgenshare.com

Organizations & group practices 6

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": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1598048407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 N HIGHLAND SPRINGS AVE # 4",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203082",
            "telephone_number": "951-769-0079",
            "fax_number": "951-845-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 N HIGHLAND SPRINGS AVE STE 4",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203082",
            "telephone_number": "951-769-0079",
            "fax_number": "888-854-7592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "ALAN",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-27",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Banning, CA

Sources for this page

Verify at the official NPI Registry.