EDILBERTO A CANSECO (NPI# 1023546025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023546025 |
| Entity Type | Individual |
| Full Name | EDILBERTO A CANSECO |
| Credential | PA |
| Practice Address |
1070 S Santa Fe Ave Vista CA 92084-7007 |
| Mailing Address |
1016 Bartlett Dr Vista CA 92084-4317 |
| Practice Telephone | 7609417050 |
| Mailing Telephone | 7602131181 |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2017-06-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 54520 | CA | Allopathic & Osteopathic Physicians |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
54520 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1070 S SANTA FE AVE |
| City | VISTA |
| State | CA |
| Zip Code | 92084-7007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619048949 | Lynn Scarborough Kirsch | Speech-Language Pathologist | 1070 S Santa Fe Ave, Suite 26-a, Vista, CA 92084-7007 | 2006-11-10 |
| 1952761058 | Rachel Villa | Nurse Practitioner | 1070 S Santa Fe Ave, #9, Vista, CA 92084-7007 | 2016-03-02 |
| 1669875266 | Alexandra Huey | Physician Assistant | 1070 S Santa Fe Ave, Suite 9, Vista, CA 92084-7007 | 2014-09-27 |
| 1194976241 | Katrina L Maxwell | Speech-Language Pathologist | 1070 S Santa Fe Ave, Suite 26a, Vista, CA 92084-7007 | 2008-10-07 |
| 1124209614 | Vista Medical Equipment | Durable Medical Equipment & Medical Supplies | 1070 S Santa Fe Ave, Suite 27, Vista, CA 92084-7007 | 2007-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912483421 | James Foster | Community Health Worker | 1020 S Santa Fe Ave Ste B1, Vista, CA 92084 | 2018-07-17 |
| 1750766192 | Olivia Del Valle | Dental Hygienist | 1000 Vale Tarrace, Vista, CA 92084 | 2015-07-28 |
| 1609288497 | May Tom | Dietitian, Registered | 29402 Spa Havens Way, Vista, CA 92084 | 2014-05-28 |
| 1972924454 | Erica Harris | Student in an Organized Health Care Education/Training Program | 300 Michigan Ave, Vista, CA 92084 | 2013-12-30 |
| 1023392008 | Timothy Wong | Pharmacist | 802 S Santa Fe Ave, Vista, CA 92084 | 2011-10-07 |
| 1811296288 | Jennifer Prince | Family Medicine | 1000 Vale Terrance Dr, Vista, CA 92084 | 2011-03-24 |
| 1093948424 | Deborah Denise Butcher | Psychologist | 1259 Sugarbush Drive, Vista, CA 92084 | 2009-09-02 |
| 1699922062 | Patricia Kay Oquist | Marriage & Family Therapist | 1370 Barbara Drive, Vista, CA 92084 | 2008-08-27 |
| 1376715045 | Steve Michael Nave | Dentist | 933 A Vale Terrace Drive, Vista, CA 92084 | 2008-04-02 |
| 1780868844 | Randell Brandon Murphy | Counselor | 1010 E Vista Way Suite F, Vista, CA 92084 | 2007-12-26 |
| Find all providers in zip 92084 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356644173 | Angela Lynn Segovia | Physician Assistant | 1070 S Santa Fe Ave Ste 10, Vista, CA 92084-7010 | 2010-12-16 |
| 1851620868 | Heather M Bland | Physician Assistant | 2023 W Vista Way Ste C, Vista, CA 92083-6030 | 2009-12-22 |
| 1124202247 | Madhuri Marelli | Physician Assistant | 2302 Amstel Ln, Vista, CA 92084-2601 | 2007-12-26 |
| 1497757728 | Jose Luis Suarez Jr. | Physician Assistant | 969 S Santa Fe Ave Ste A, Vista, CA 92083-6910 | 2005-05-31 |
| 1770721714 | Regina Lynn Petersen | Physician Assistant | 145 Thunder Dr, Vista, CA 92083-6010 | 2009-01-29 |
| 1053409920 | Paula Sorrentino | Physician Assistant | 145 Thunder Dr, Vista, CA 92083-6010 | 2006-10-10 |
| 1922087253 | Armando Baza-vargas | Physician Assistant | 969 S Santa Fe Ave Ste A, Vista, CA 92083-6910 | 2006-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.