Gina R Erdahl, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA21561 Issued in CA

Practice address

1415 Ross Ave
El Centro, CA 92243-4306

Phone

(760) 339-7100

Fax

(790) 482-5180

NPI assigned

Aug 5, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Regents of the University of California

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1780870899
  Medicare reassignment NPD
• Sharp Rees-Stealy Medical Group, Inc

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1285616177

  Physician Assistant

  Medicare reassignment NPD
• Sharp Rees-Stealy Medical Group, Inc

  • Optometrist
  • San Diego, CA
  • NPI 1063172351
  NPD
• El Centro Regional Medical Center

  • Rural Health Clinic/Center
  • Calexico, CA
  • NPI 1598840258
  NPD (past)
• Regents of the University of California

  • Pharmacy
  • San Diego, CA
  • NPI 1598786576
  NPD (past)
• Regents of the University of California Ucsd Head and Neck Surgery

  • Otolaryngology Physician
  • San Diego, CA
  • NPI 1679509962
  NPD (past)
• Regents of the Unviersity of California

  • Emergency Medicine Physician
  • La Jolla, CA
  • NPI 1629095500
  NPD (past)

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

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312502400000",
    "number": "1801175070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 ROSS AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434306",
            "telephone_number": "760-339-7100",
            "fax_number": "790-482-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 ROSS AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434306",
            "telephone_number": "760-339-7100",
            "fax_number": "790-482-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERDAHL",
        "first_name": "GINA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-05",
        "last_updated": "2011-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA21561",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kimberly Elmore, PHARMD
• Evelyn Encinas
• Alexis Danitza Enriquez
• Ivanna Graciela Escalante
• Tiffani A Escalante
• Laura Escalera
• Guadalupe Escobedo, BCABA
• Ricardo Escobedo Jr.

• Physician Assistant in El Centro, CA
• Providers in El Centro, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; 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.

Verify at the official NPI Registry.