David Picella PHD Inc

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

DAVID PICELLA PHD INC

Practice address

7121 Mackinaw CT
Eastvale, CA 91752-1492

Phone

(877) 241-8200

Fax

(909) 245-1751

NPI assigned

Aug 11, 2015

Organization subpart

No

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

Authorized official

Name

Mr. David V Picella, PHD, NP

Title

President

Phone

(877) 241-8200

Specialties & licenses 3

Addresses

Other names 1

• Omega Healthcare Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• David Picella PHD Inc

  • Nurse Practitioner
  • Pomona, CA
  • NPI 1689057960

  O20150915001207

  Same enrollment

Tax ID family

David Picella PHD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• David Picella PHD Inc

  • Nurse Practitioner
  • Pomona, CA
  • NPI 1689057960
  NPD tax ID

Locations

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533254400000",
    "number": "1942686142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 N DEL SOL LN",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651105",
            "telephone_number": "877-241-8200",
            "fax_number": "909-245-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7121 MACKINAW CT",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "917521492",
            "telephone_number": "877-241-8200",
            "fax_number": "909-245-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID PICELLA PHD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-11",
        "last_updated": "2018-08-03",
        "status": "A",
        "authorized_official_last_name": "PICELLA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "877-241-8200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD, NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omega Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Omega Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric D Crothers, APRN, CRNA
• Jezreel Cruz, AGPCNP-BC
• Mark Cuenco
• Anish Dalal
• Mina Nghi Dang
• Davita Riverside II LLC
• Sabrina Dea
• Dellbrook Guest Home
• Dellbrook Guest Home II
• Palak Desai

• All providers in Eastvale, CA
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.