Active NPI
Debra Ann Blanco, PA-C
- Physician Assistant
- Ontario, CA
National Provider Identifier
1740372366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 14845
- Practice address
- 437 N Euclid Ave
Suite a
Ontario, CA 91762-3456 - Phone
- (909) 988-2555
- Fax
- (909) 988-4447
- NPI assigned
- Sep 29, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 14845 | CA | Primary |
Addresses
Primary practice location
437 N Euclid Ave
Suite a
Ontario, CA 91762-3456
Mailing address
437 N Euclid Ave
Suite a
Ontario, CA 91762-3456
Phone (909) 988-2555
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 14845 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Santa Rita Medical Center | Past | Accepting new patients | |
| Lincoln Heights Family & Industrial Medical Clinic | Physician Assistant | Past | Accepting new patients |
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.
-
dba Blanco Family Medicine
- Primary Care Clinic/Center
- Covina, CA
- NPI 1922424902
-
dba Sunrise Medical Center
- Obstetrics & Gynecology Nurse Practitioner
- Ontario, CA
- NPI 1912111543
Physician Assistant
-
- Family Medicine Physician
- Ontario, CA
- NPI 1407964919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740372366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "437 N EUCLID AVE",
"address_2": "SUITE A",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917623456",
"telephone_number": "909-988-2555",
"fax_number": "909-988-4447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "437 N EUCLID AVE",
"address_2": "SUITE A",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917623456",
"telephone_number": "909-988-2555",
"fax_number": "909-988-4447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANCO",
"first_name": "DEBRA",
"middle_name": "ANN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA 14845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.