Vicente Javellana Arano, M. D.
Individual provider Active NPI Family Medicine Physician · Yucca Valley, CA
NPI 1790885259 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1790885259
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A55658 (CA)
- Practice address
- 57445 29-Palms Highway
Suite 303
Yucca Valley, CA 92284-2947 - Phone
- (760) 369-1262
- Fax
- (760) 369-1253
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|---|
| I20100506000247 | CA | Practitioner - Family Practice | 6002944469 | Practice locations: Chino, CA; Yucca Valley, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A55658 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yucca Valley Family Medical Associates, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A55658 | CA | Yes |
Addresses
Primary practice location
57445 29-Palms Highway
Suite 303
Yucca Valley, CA 92284-2947
Mailing address
57445 29-Palms Highway
Suite 303
Yucca Valley, CA 92284-2947
Phone (760) 369-1262
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A556580 | Medicaid | CA |
Other providers in Yucca Valley, CA
- James D. Anderson
- Jennifer Anderson
- Angelic Mansions, LLC
- Elena Angioi
- Anil G Indulkar Pharmacist a Professional Corp
- Archangel Hospice, LLC.
- Ramona Arechiga
- Esteban Arellano-Risher
- Beverly M Ary
- Mary Ary
All providers in Yucca Valley, 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 Mar 7, 2023. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.