Active NPI
Mirta C Delgado, DO
- Pediatrics Physician
- Redwood City, CA
National Provider Identifier
1720040322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20A 10417
- Practice address
- 630 Laurel St
Redwood City, CA 94063-2977 - Phone
- (650) 261-3710
- NPI assigned
- Apr 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 222257 | NY | |
| Pediatrics Physician | 208000000X | 20A 10417 | CA | Primary |
Addresses
Primary practice location
630 Laurel St
Redwood City, CA 94063-2977
Mailing address
630 Laurel St
Redwood City, CA 94063-2977
Phone (650) 261-3710
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
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A 10417 | CA | MD | Pediatrics Physician |
| 222257 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232409600000",
"number": "1720040322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 LAUREL ST",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940632977",
"telephone_number": "650-261-3710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 LAUREL ST",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940632977",
"telephone_number": "650-261-3710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELGADO",
"first_name": "MIRTA",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-06",
"last_updated": "2009-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "222257",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "20A 10417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.