Individual provider Active NPI

Juan Atlacatl Alas-Pocasangre, M.D.

  • Family Medicine Physician
  • La Puente, CA
National Provider Identifier
1720189186
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A56155 Issued in CA
Practice address
18335 Valley Blvd
La Puente, CA 91744-5968
Phone
(626) 810-3330
Fax
(626) 964-0440
NPI assigned
Sep 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A56155 CA Primary

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

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050818000294 CA Practitioner - Family Practice 5698705796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
56155CAMDPharmacist
A56155CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Antonio Medical Clinic, Inc. CurrentSince Oct 4, 2007 Accepting new patients
Alas Medical Clinic, Inc. Past Accepting new patients
St Jude Hospital Inc PastSince Oct 4, 2007 Accepting new patients

Locations

325 E La Habra Blvd
La Habra, CA 90631
Phone (562) 691-7100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720189186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18335 VALLEY BLVD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917445968",
            "telephone_number": "626-810-3330",
            "fax_number": "626-964-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18335 VALLEY BLVD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917445968",
            "telephone_number": "626-810-3330",
            "fax_number": "626-964-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAS-POCASANGRE",
        "first_name": "JUAN",
        "middle_name": "ATLACATL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A56155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Puente, CA

Sources for this page

Verify at the official NPI Registry.