Individual provider Active NPI

Abel R Quesada, M.D.

  • General Practice Physician
  • Vernon, CA
National Provider Identifier
1881885101
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A100315 Issued in CA
Practice address
4221 S Alameda St
Vernon, CA 90058-1601
Phone
(323) 676-5111
Fax
(323) 676-5112
NPI assigned
Aug 5, 2007
Last updated
Oct 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A100315 CA Primary

Addresses

Primary practice location

4221 S Alameda St
Vernon, CA 90058-1601

Mailing address

1125 E Broadway # 251
Glendale, CA 91205-1315
Phone (323) 676-5111

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151030002250 CA Order and Referring Only - General PracticePractitioner - General Practice 0345550521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A100315CAMDGeneral Practice Physician

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1881885101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 E BROADWAY # 251",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051315",
            "telephone_number": "323-676-5111",
            "fax_number": "323-676-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 S ALAMEDA ST",
            "city": "VERNON",
            "state": "CA",
            "postal_code": "900581601",
            "telephone_number": "323-676-5111",
            "fax_number": "323-676-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUESADA",
        "first_name": "ABEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A100315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, CA

Sources for this page

Verify at the official NPI Registry.