Individual provider Active NPI

Edgar N Ibay, IDC

  • Independent Duty Corpsman
  • Chula Vista, CA
National Provider Identifier
1801232236
Registry record updated May 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
1992 Caminito de la Cruz
Chula Vista, CA 91913
Phone
(760) 828-3833
NPI assigned
May 13, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Primary

Addresses

Primary practice location

1992 Caminito de la Cruz
Chula Vista, CA 91913

Mailing address

1992 Caminito de la Cruz
Chula Vista, CA 91913
Phone (760) 828-3833

Other identifiers 1

IdentifierTypeStateIssuer
1710-1002XOtherIDC

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": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368403200000",
    "number": "1801232236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1992 CAMINITO DE LA CRUZ",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91913",
            "telephone_number": "760-828-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1992 CAMINITO DE LA CRUZ",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91913",
            "telephone_number": "760-828-3833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBAY",
        "first_name": "EDGAR",
        "middle_name": "N",
        "credential": "IDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-13",
        "last_updated": "2013-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDC",
            "identifier": "1710-1002X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; 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.