DR. JOHN ELAZEGUI NEPOMUCENO (NPI# 1477673770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477673770 |
| Entity Type | Individual |
| Full Name | DR. JOHN ELAZEGUI NEPOMUCENO |
| Credential | MD |
| Practice Address |
1520 Collyer Dr Redding CA 96003-9535 |
| Mailing Address |
Po Box 992337 Redding CA 96099-2337 |
| Practice Telephone | 7024533799 |
| Practice Fax Number | 5302431612 |
| Mailing Telephone | 7024533799 |
| Mailing Fax Number | 5302431612 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2019-06-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | C50728 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0094270 | 05 |
| Street Address |
1520 COLLYER DR |
| City | REDDING |
| State | CA |
| Zip Code | 96003-9535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144882309 | Patricia Price | Social Worker | 2280 Benton Dr Building C, Suite A, Redding, CA 96003 | 2019-07-08 |
| 1487102745 | Jill Marie Shepherd Piercy Clark | Psychologist | 1465 Victor Ave Ste B, Redding, CA 96003 | 2016-09-15 |
| 1811344450 | Roger Milton Slagle | Social Worker | 999 Mission De Oro Dr Ste 103, Redding, CA 96003 | 2016-05-23 |
| 1265713812 | Tesha Marie Huston | Pharmacist | 975 Cypress Ave, Redding, CA 96003 | 2011-09-08 |
| 1861717605 | Western Physical Therapy Inc | Physical Therapist | 1495 Victor Ave, Suite D, Redding, CA 96003 | 2010-04-05 |
| 1013230036 | Douglas Norman Porter | Psychologist | 748 North Market St., Redding, CA 96003 | 2010-03-04 |
| 1821232877 | Express Medi-trans, Inc. | Non-emergency Medical Transport (VAN) | 2985 Innsbruck Dr, Redding, CA 96003 | 2009-04-21 |
| 1235393000 | Bridget Gabrielle Young | Physical Therapist | 2021 Benton Dr, Redding, CA 96003 | 2008-07-10 |
| 1447427406 | Terra Bella Communities | Nursing Facility/Intermediate Care Facility | 280 Riverpark Drive, Redding, CA 96003 | 2008-05-09 |
| 1588830657 | Terra Bella Communities | Intermediate Care Facility, Mentally Retarded | 237 Shadowrun Ct., Redding, CA 96003 | 2008-05-07 |
| Find all providers in zip 96003 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013253921 | William Jude Mccabe | Family Medicine | 13490 Tierra Heights Rd, Redding, CA 96003-7481 | 2012-12-20 |
| 1366709883 | Joe Carroll O'banion | Family Medicine | 910 Hallmark Dr, Redding, CA 96001-0149 | 2012-04-20 |
| 1235409723 | Cristine Osborne | Family Medicine | 2941 Montana Sky Dr, Redding, CA 96002-5155 | 2011-12-30 |
| 1235429572 | Jesse Graham Livingston | Family Medicine | 3611 Steamboat St, Redding, CA 96003-5317 | 2011-04-07 |
| 1285868323 | Julie Jeyaratnam | Family Medicine | 2510 Airpark Dr Ste 201, Redding, CA 96001-2461 | 2009-05-04 |
| 1174785489 | Maria De Lourdes Nicora Bia | Family Medicine | 100 East Cypress, Redding, CA 96002-0000 | 2008-06-27 |
| 1881716256 | Morris Robert Ballard | Family Medicine | 1115 Whiskeytown Ct # B, Redding, CA 96001-0227 | 2007-04-04 |
| 1801912332 | The Family Practice Center | Family Medicine | 3310 Churn Creek Rd Ste B, Redding, CA 96002-2513 | 2007-03-22 |
| 1013061647 | Randall James Lankford | Family Medicine | 5814 Old Barn Way, Redding, CA 96001-4654 | 2007-01-22 |
| 1629149984 | Ballard Medical Corporation | Family Medicine | 1115 Whiskeytown Ct, Suite B, Redding, CA 96001-0227 | 2006-11-10 |
| Find all providers in REDDING | ||||
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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.