Individual provider Active NPI

Carlos David Frausto, MSPA, PA-C

  • Medical Physician Assistant
  • Temecula, CA
National Provider Identifier
1720683246
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA58908 Issued in CA
Practice address
29645 Rancho California Rd Ste 118
Temecula, CA 92591-5285
Phone
(951) 506-0187
Fax
(951) 506-0189
NPI assigned
Dec 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA58908 CA Primary
Physician Assistant 363A00000X CA

Addresses

Primary practice location

29645 Rancho California Rd Ste 118
Temecula, CA 92591-5285

Mailing address

31740 Silk Vine Dr
Winchester, CA 92596-8626
Phone (951) 538-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Feb 12, 2026 through Feb 12, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA58908CAMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1720683246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31740 SILK VINE DR",
            "city": "WINCHESTER",
            "state": "CA",
            "postal_code": "925968626",
            "telephone_number": "951-538-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29645 RANCHO CALIFORNIA RD STE 118",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925915285",
            "telephone_number": "951-506-0187",
            "fax_number": "951-506-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAUSTO",
        "first_name": "CARLOS",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MSPA, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-02",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA58908",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.