Active NPI
Hortensia Lara, MD
- Physician Assistant
- San Diego, CA
National Provider Identifier
1649329293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA11825
- Practice address
- 3860 Calle Fortunada
Ste 200
San Diego, CA 92123-4800 - Phone
- (858) 636-4300
- Fax
- (858) 636-4319
- NPI assigned
- Jan 10, 2007
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA11825 | CA | Primary |
Addresses
Primary practice location
3860 Calle Fortunada
Ste 200
San Diego, CA 92123-4800
Mailing address
3860 Calle Fortunada
Ste 200
San Diego, CA 92123-4800
Phone (858) 636-4300
Other names 1
- Hortensia Lara
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA11825 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296518400000",
"number": "1649329293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3860 CALLE FORTUNADA",
"address_2": "STE 200",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234800",
"telephone_number": "858-636-4300",
"fax_number": "858-636-4319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3860 CALLE FORTUNADA",
"address_2": "STE 200",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234800",
"telephone_number": "858-636-4300",
"fax_number": "858-636-4319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARA",
"first_name": "HORTENSIA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2011-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA11825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HORTENSIA",
"last_name": "LARA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.