Active NPI
I. Acosta, M.D., Inc.
- Surgery Physician
- Glendale, CA
National Provider Identifier
1649474800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- A26640
- Legal business name
- I. ACOSTA, M.D., INC.
- Practice address
- 1808 Verdugo Blvd
Suite 409
Glendale, CA 91208-1477 - Phone
- (818) 790-8020
- Fax
- (818) 790-9313
- NPI assigned
- Jun 12, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ignacio Acosta, MD
- Title
- President Owner
- Phone
- (818) 790-8020
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | A26640 | CA | Primary |
Addresses
Primary practice location
1808 Verdugo Blvd
Suite 409
Glendale, CA 91208-1477
Mailing address
1808 Verdugo Blvd
Suite 409
Glendale, CA 91208-1477
Phone (818) 790-8020
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DO4784 | Other | RAILROAD MEDICARE PTAN | |
| 0004033429 | Other | CA | AETNA ID |
| 00A266400 | Other | CA | BLUE SHIELD ID |
| 00A266401 | Medicaid | CA | |
| 000767453 | Other | CA | APWU ID |
| 300000306091 | Other | CA | PLAN HANDLERS ID |
National Provider Directory
National Provider DirectoryLocations
1808 Verdugo Blvd
Ste 409
Glendale, CA 91208
Phone (818) 790-8020
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1241395200000",
"number": "1649474800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1808 VERDUGO BLVD",
"address_2": "SUITE 409",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912081477",
"telephone_number": "818-790-8020",
"fax_number": "818-790-9313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1808 VERDUGO BLVD",
"address_2": "SUITE 409",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912081477",
"telephone_number": "818-790-8020",
"fax_number": "818-790-9313"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "I. ACOSTA, M.D., INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-12",
"last_updated": "2009-05-04",
"status": "A",
"authorized_official_last_name": "ACOSTA",
"authorized_official_first_name": "IGNACIO",
"authorized_official_title_or_position": "PRESIDENT OWNER",
"authorized_official_telephone_number": "818-790-8020",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": "CA",
"license": "A26640",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PTAN",
"identifier": "DO4784",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA ID",
"identifier": "0004033429",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD ID",
"identifier": "00A266400",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A266401",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APWU ID",
"identifier": "000767453",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PLAN HANDLERS ID",
"identifier": "300000306091",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.