Active NPI
Daniel Iracheta, PA-C
- Hospitalist Physician
- Loma Linda, CA
National Provider Identifier
1659067452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- PA63428
- Practice address
- 1795 Gould St
Loma Linda, CA 92354-1716 - Phone
- (909) 838-3335
- NPI assigned
- Apr 13, 2023
- Last updated
- Oct 3, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | PA63428 | CA | Primary |
Addresses
Primary practice location
1795 Gould St
Loma Linda, CA 92354-1716
Mailing address
1795 Gould St
Loma Linda, CA 92354-1716
Phone (909) 838-3335
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA63428 | CA | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - California | Current | Accepting new patients | |
| Cep America-California | Current | Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125
4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Murrieta, CA
- NPI 1588552848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696291200000",
"number": "1659067452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1795 GOULD ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923541716",
"telephone_number": "909-838-3335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1795 GOULD ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923541716",
"telephone_number": "909-838-3335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRACHETA",
"first_name": "DANIEL",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-13",
"last_updated": "2023-10-03",
"certification_date": "2023-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "CA",
"license": "PA63428",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.