Active NPI
Queenie David, MD
- Nurse Practitioner
- Signal Hill, CA
National Provider Identifier
1982762472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 14815
- Practice address
- 2704 E Willow St
Signal Hill, CA 90755-2217 - Phone
- (562) 595-0203
- Fax
- (562) 595-0062
- NPI assigned
- Dec 5, 2006
- Last updated
- Dec 6, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 14815 | CA | Primary |
Addresses
Primary practice location
2704 E Willow St
Signal Hill, CA 90755-2217
Mailing address
2704 E Willow St
Signal Hill, CA 90755-2217
Phone (562) 595-0203
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
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14815 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1982762472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2704 E WILLOW ST",
"city": "SIGNAL HILL",
"state": "CA",
"postal_code": "907552217",
"telephone_number": "562-595-0203",
"fax_number": "562-595-0062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2704 E WILLOW ST",
"city": "SIGNAL HILL",
"state": "CA",
"postal_code": "907552217",
"telephone_number": "562-595-0203",
"fax_number": "562-595-0062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVID",
"first_name": "QUEENIE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2021-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "14815",
"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": "6041 Cadillac Ave",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900341702",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Signal Hill, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.