Active NPI
Pedro Delfin Jr., NP
- Nurse Practitioner
- Long Beach, CA
National Provider Identifier
1689738759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 12389
- Practice address
- 2801 Atlantic Ave
Trauma Services
Long Beach, CA 90806-1701 - Phone
- (562) 933-1315
- Fax
- (562) 933-1325
- NPI assigned
- Dec 21, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 12389 | CA | Primary |
Addresses
Primary practice location
2801 Atlantic Ave
Trauma Services
Long Beach, CA 90806-1701
Mailing address
2801 Atlantic Ave
Trauma Services
Long Beach, CA 90806-1701
Phone (562) 933-1315
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12389 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185494400000",
"number": "1689738759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 ATLANTIC AVE",
"address_2": "TRAUMA SERVICES",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908061701",
"telephone_number": "562-933-1315",
"fax_number": "562-933-1325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 ATLANTIC AVE",
"address_2": "TRAUMA SERVICES",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908061701",
"telephone_number": "562-933-1315",
"fax_number": "562-933-1325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELFIN",
"first_name": "PEDRO",
"name_suffix": "Jr.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-21",
"last_updated": "2007-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "12389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.