Individual provider Active NPI

Paul Murphy De Vera Quiambao, FNP-C

  • Family Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1669236030
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95027951 Issued in CA
Practice address
801 S Chevy Chase Dr Ste 250
Glendale, CA 91205-4433
Phone
(818) 630-2241
NPI assigned
Feb 7, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95027951 CA Primary

Addresses

Primary practice location

801 S Chevy Chase Dr Ste 250
Glendale, CA 91205-4433

Mailing address

308 Palm CT
Carson, CA 90745-3100
Phone (310) 302-7617

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240410001767 CA Practitioner - Nurse Practitioner 3173961174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

801 S Chevy Chase Dr
Suite 250
Glendale, CA 91205-4433
Phone (818) 265-2264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95027951CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Community Health Centers Inc CurrentSince Feb 26, 2024 Accepting new patients
Comprehensive Community Health Centers, Inc CurrentSince Feb 26, 2024 Accepting new patients
Comprehensive Community Health Centers Inc Past Accepting new patients

Locations

801 S Chevy Chase Dr
Ste 250
Glendale, CA 91205
Phone (818) 265-2259

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1669236030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 PALM CT",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907453100",
            "telephone_number": "310-302-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S CHEVY CHASE DR STE 250",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054433",
            "telephone_number": "818-630-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIAMBAO",
        "first_name": "PAUL MURPHY",
        "middle_name": "DE VERA",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95027951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.