Individual provider Active NPI

Edgar Leonardo Farias

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1992468623
Registry record updated Sep 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PA60614 Issued in CA
Practice address
1414 E Florence Ave
Los Angeles, CA 90001-1937
Phone
(323) 588-1383
NPI assigned
Oct 19, 2021
Last updated
Sep 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA60614 CA Primary

Addresses

Primary practice location

1414 E Florence Ave
Los Angeles, CA 90001-1937

Mailing address

1414 E Florence Ave
Los Angeles, CA 90001-1937
Phone (323) 588-1383

Other practice location 1

5901 Niles St Ste A
Bakersfield, CA 93306-4781
Phone (661) 363-7232

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
I20240625003307 CA Practitioner - Physician Assistant 7810430303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Zacoalco Medical Group IncGroup PAC ID 4183667629, 5 clinicians

Practice addresses (Care Compare)

1414 E Florence Ave
Los Angeles, CA 90001-1937
Phone (323) 588-1383

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60614CAMDPharmacist
PA60614CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Zacoalco Medical Group Inc Family Medicine Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790380800000",
    "number": "1992468623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 E FLORENCE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900011937",
            "telephone_number": "323-588-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 E FLORENCE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900011937",
            "telephone_number": "323-588-1383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5901 Niles St Ste A",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933064781",
            "country_code": "US",
            "telephone_number": "661-363-7232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARIAS",
        "first_name": "EDGAR",
        "middle_name": "LEONARDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-19",
        "last_updated": "2026-09-26",
        "certification_date": "2026-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA60614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.