Active NPI
Mitos Rachel Roa Daling
- Family Nurse Practitioner
- Harbor City, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95017489
- Practice address
- 25825 Vermont Ave
Harbor City, CA 90710-3518 - Phone
- (310) 721-9344
- NPI assigned
- Sep 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 721799 | CA | |
| Family Nurse Practitioner | 363LF0000X | 95017489 | CA | Primary |
Addresses
Primary practice location
25825 Vermont Ave
Harbor City, CA 90710-3518
Mailing address
25825 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 721-9344
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230509001582 | CA | Practitioner - Nurse Practitioner | 0042676439 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
25821 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111
25825 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111
25965 Normandie Ave
Harbor City, CA 90710-3416
Phone (310) 325-5111
25975 Normandie Ave
Harbor City, CA 90710-3416
Phone (310) 257-6115
4477 W 118TH St
Suite 402
Hawthorne, CA 90250-2259
Phone (805) 664-1955
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Philip J. Morgan, M.D., Apc | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111
4477 W 118th St
Ste 402
Hawthorne, CA 90250
Phone (310) 644-1151
393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235
3442 Loma Vista Rd
Ste B
Ventura, CA 93003
Phone (805) 664-1955
6325 Topanga Canyon Blvd
Ste 412
Woodland Hls, CA 91367
Phone (818) 483-6334
Organizations & group practices 4
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
CA
-
- Health Maintenance Organization
- Hawthorne, CA
- NPI 1164914115
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735516800000",
"number": "1972118263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25825 VERMONT AVE",
"city": "HARBOR CITY",
"state": "CA",
"postal_code": "907103518",
"telephone_number": "310-721-9344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25825 VERMONT AVE",
"city": "HARBOR CITY",
"state": "CA",
"postal_code": "907103518",
"telephone_number": "310-721-9344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALING",
"first_name": "MITOS RACHEL",
"middle_name": "ROA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-13",
"last_updated": "2024-12-30",
"certification_date": "2022-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "721799",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95017489",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "25825 Vermont Ave",
"city": "Harbor City",
"state": "CA",
"country_code": "US",
"postal_code": "907103518",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Harbor City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.