Individual provider Active NPI

Robert Vega, PA-C

  • Physician Assistant
  • Downey, CA
National Provider Identifier
1962530071
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16704 Issued in CA
Practice address
7601 Imperial Hwy
Dept. of Surgery
Downey, CA 90242-3456
Phone
(562) 401-7167
Fax
(562) 401-6247
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16704 CA Primary

Addresses

Primary practice location

7601 Imperial Hwy
Dept. of Surgery
Downey, CA 90242-3456

Mailing address

24171 High Knob Rd
Unit # D
Diamond Bar, CA 91765-4272
Phone (626) 542-8417

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090528000422 CA Practitioner - Physician Assistant 8628127354 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA16704CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Mar 25, 2009 Accepting new patients
County of Los Angeles Auditor Controller Physician Assistant CurrentSince Mar 25, 2009 Accepting new patients

Locations

7601 Imperial Hwy
Downey, CA 90242
Phone (310) 940-8111

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962530071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24171 HIGH KNOB RD",
            "address_2": "UNIT # D",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654272",
            "telephone_number": "626-542-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 IMPERIAL HWY",
            "address_2": "DEPT. OF SURGERY",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902423456",
            "telephone_number": "562-401-7167",
            "fax_number": "562-401-6247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.