Saul De la Rosa, PA PHYSICIAN ASSISTA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13049 Issued in CA

Practice address

1414 E Florence Ave
Zacoalco Med Group
Los Angeles, CA 90001

Phone

(323) 588-1383

Fax

(323) 588-2339

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 1990

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Zacoalco Medical Group IncGroup PAC ID 4183667629, 5 clinicians

Zacoalco Urgent Care Center IncGroup PAC ID 8123380060, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Zacoalco Medical Group Inc

  • Family Medicine Physician
  • Bakersfield, CA
  • NPI 1679626170
  Medicare reassignment Care Compare group Authorized official
• Zacoalco Urgent Care Center Inc

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1669620563
  Medicare reassignment Care Compare group Authorized official
• Zacoalco Medical Group Inc

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1750442836
  NPD

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669554705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 E FLORENCE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90001",
            "telephone_number": "323-588-1383",
            "fax_number": "323-588-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 E FLORENCE AVE",
            "address_2": "ZACOALCO MED GROUP",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90001",
            "telephone_number": "323-588-1383",
            "fax_number": "323-588-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA ROSA",
        "first_name": "SAUL",
        "name_prefix": "Mr.",
        "credential": "PA PHYSICIAN ASSISTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0080240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Astrid De la Rosa
• Cindy De la Rosa
• Marelyn De la Rosa
• Maria Edna Alabastro De la Rosa
• Roxana Gilda De la Rosa, O.D.
• Stephanie De la Rosa
• Yecenia De la Rosa
• Miguel Omar De la Torre Avitia, MD
• Andre Dion De la Torre
• Clezette Darlene De la Torre

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.