Individual provider Active NPI

Virginia Ann Floco, PA

  • Surgical Physician Assistant
  • San Diego, CA
National Provider Identifier
1982798112
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA20788 Issued in CA
Practice address
3030 Childrens Way Ste 402
San Diego, CA 92123-4228
Phone
(858) 309-7701
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA20788 CA Primary

Addresses

Primary practice location

3030 Childrens Way Ste 402
San Diego, CA 92123-4228

Mailing address

3020 Childrens Way # Mc5003
San Diego, CA 92123-4223
Phone (858) 309-6300

Other names 1

  • Virginia Ann Lee Former name

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
I20150917003177 CA Practitioner - Physician Assistant 3375648710 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA20788CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rady Children'S Hospital San Diego CurrentSince Oct 23, 2021 Accepting new patients
Rady Children'S Hospital San Diego CurrentSince Oct 23, 2021 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients

Locations

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

3030 Childrens Way
Ste 402
San Diego, CA 92123
Phone (858) 309-7701

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1982798112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 CHILDRENS WAY STE 402",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234228",
            "telephone_number": "858-309-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOCO",
        "first_name": "VIRGINIA",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA20788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIRGINIA",
            "last_name": "LEE",
            "middle_name": "ANN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.