Jose Dejesus Ruvalcaba, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA23065 Issued in CA

Practice address

813 E Francis Ave
La Habra, CA 90631-4003

Phone

(562) 665-4638

NPI assigned

Aug 10, 2013

Last updated

Aug 10, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jose Dejesus Limon Other name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1376092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376092800000",
    "number": "1598198897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 E FRANCIS AVE",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906314003",
            "telephone_number": "562-665-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 E FRANCIS AVE",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906314003",
            "telephone_number": "562-665-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUVALCABA",
        "first_name": "JOSE",
        "middle_name": "DEJESUS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-10",
        "last_updated": "2013-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA23065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSE",
            "last_name": "LIMON",
            "middle_name": "DEJESUS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physician Assistant in La Habra, CA
• Providers in La Habra, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2013; 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.