Individual provider Active NPI

Dina L Villapudua, PA

  • Physician Assistant
  • Buena Park, CA
National Provider Identifier
1992871941
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
18416 Issued in CA
Practice address
9502 Monterra Way
Buena Park, CA 90620-4260
Phone
(714) 469-8868
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 18416 CA Primary
Obstetrics & Gynecology Physician 207V00000X PA 18416 CA

Addresses

Primary practice location

9502 Monterra Way
Buena Park, CA 90620-4260

Mailing address

9502 Monterra Way
Buena Park, CA 90620-4260
Phone (714) 469-8868

Other identifiers 2

IdentifierTypeStateIssuer
GR0097000OtherCAPROVIDER NUMBER
GR0097001OtherCAPROVIDER NUMBER

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
I20110308001024 CA Practitioner - Physician Assistant 4385826635 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carbon Health Medical Group of California PCGroup PAC ID 9032340047, 335 clinicians
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

10165 Valley View St
Cypress, CA 90630-4602
Phone (714) 252-5016

1040 W Imperial Hwy
Suite D
La Habra, CA 90631-0608
Phone (714) 451-1072

12601 Garden Grove Blvd
Garden Grove, CA 92843-1908
Phone (714) 537-5160

13299 S St
Cerritos, CA 90703-7307
Phone (562) 865-8750

13365 W Washington Blvd
Los Angeles, CA 90066-5134
Phone (310) 504-1825

14443 Culver Dr
14443 A
Irvine, CA 92604-0343
Phone (949) 767-8173

2010 E Carson St
Long Beach, CA 90807-3040
Phone (562) 424-5450

3851 Katella Ave
Suite 100
Los Alamitos, CA 90720-3385
Phone (562) 430-4138

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 18416CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of California PC CurrentSince Nov 25, 2021 Accepting new patients
Cep America - California CurrentSince Feb 10, 2013 Accepting new patients
Memorial Emergency Physicians Medical Group, Inc Past Accepting new patients
Cep America - California Past Accepting new patients

Locations

11971 Central Ave
Ste B
Chino, CA 91710
Phone (909) 310-1488

3955 Bedford Canyon Rd
Unit 103
Corona, CA 92883
Phone (951) 293-4722

12601 Garden Grove Blvd
Garden Grove, CA 92843
Phone (714) 537-5160

14443 Culver Dr
#14443A
Irvine, CA 92604
Phone (949) 767-8173

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

806 New Los Angeles Ave
Moorpark, CA 93021
Phone (805) 334-8650

2944 Tapo Canyon Rd
Ste A
Simi Valley, CA 93063
Phone (805) 306-5990

Organizations & group practices 9

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1992871941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9502 MONTERRA WAY",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204260",
            "telephone_number": "714-469-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9502 MONTERRA WAY",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204260",
            "telephone_number": "714-469-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAPUDUA",
        "first_name": "DINA",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "18416",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "PA 18416",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "GR0097000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "GR0097001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

Verify at the official NPI Registry.