Individual provider Active NPI

Chad Tiradeau

  • Driver
  • Diamond Bar, CA
National Provider Identifier
1649986415
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
D8719994 Issued in CA
Practice address
23645 Prospect Valley Dr
Diamond Bar, CA 91765-1635
Phone
(949) 433-3206
NPI assigned
Jan 25, 2023
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X D8719994 CA Primary

Addresses

Primary practice location

23645 Prospect Valley Dr
Diamond Bar, CA 91765-1635

Mailing address

23645 Prospect Valley Dr
Diamond Bar, CA 91765-1635
Phone (949) 433-3206

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

State licenses

LicenseStateTypeSpecialty
D8719994CAMDDriver

Practice roles

OrganizationSpecialtyStatusNew patients
Coast 2 Coast Transportation CurrentSince Feb 26, 2023 Accepting new patients
Coast 2 Coast Transportation CurrentSince Feb 8, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1649986415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23645 PROSPECT VALLEY DR",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651635",
            "telephone_number": "949-433-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23645 PROSPECT VALLEY DR",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651635",
            "telephone_number": "949-433-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRADEAU",
        "first_name": "CHAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "CA",
            "license": "D8719994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Bar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.