Individual provider Active NPI

Pablo Guillermo Small

  • Student in an Organized Health Care Education/Training Program
  • Tustin, CA
National Provider Identifier
1730996976
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
18302 Irvine Blvd Ste 375
Tustin, CA 92780-3435
Phone
(714) 661-5390
NPI assigned
Dec 11, 2024
Last updated
Mar 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA Primary

Addresses

Primary practice location

18302 Irvine Blvd Ste 375
Tustin, CA 92780-3435

Mailing address

540 N Dexford Dr
La Habra, CA 90631-4353
Phone (562) 631-1839

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1730996976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 N DEXFORD DR",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906314353",
            "telephone_number": "562-631-1839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18302 IRVINE BLVD STE 375",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803435",
            "telephone_number": "714-661-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "PABLO",
        "middle_name": "GUILLERMO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-11",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.