Juan Atlacatl Alas-Pocasangre, M.D.
Individual provider Active NPI Family Medicine Physician · La Puente, CA
NPI 1720189186 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720189186
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A56155 (CA)
- Practice address
- 18335 Valley Blvd
La Puente, CA 91744-5968 - Phone
- (626) 810-3330
- Fax
- (626) 964-0440
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
325 E la Habra Blvd
La Habra, CA 90631-5439
Phone (562) 691-7100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050818000294 | CA | Practitioner - Family Practice | 5698705796 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A56155 | CA | MD | Family Medicine Physician |
Practice roles (3 of 4)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Antonio Medical Clinic, Inc. | Current |
Accepting new patients | |
| St Jude Hospital Inc | Past |
Accepting new patients | |
| Alas Medical Clinic, Inc. | Past | Accepting new patients |
Locations
325 E La Habra Blvd
La Habra, CA 90631
Phone (562) 691-7100
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A56155 | CA | Yes |
Addresses
Primary practice location
18335 Valley Blvd
La Puente, CA 91744-5968
Mailing address
18335 Valley Blvd
La Puente, CA 91744-5968
Phone (626) 810-3330
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A561550 | Medicaid | CA |
Other providers in La Puente, CA
- Sandra Aguilar
- Christopher Aguirre
- Virginia Ipapo Agustin
- Ak Pharma, Inc.
- Andres Alamillo
- Blanca Estela Rodriguez Alcala
- Brian Rex Alcalde
- Alejandro Saichin
- Alex Marose DDS Inc.
- All-Time Medical Interpreting LLC
All providers in La Puente, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.