NPI Code Detail JSON Logo

1457934648 NPI number — ELLEN J DELOYA DO

NPI Number: 1457934648
Health Care Provider/Practitioner: ELLEN J DELOYA DO

Information about “1457934648” NPI (ELLEN J DELOYA DO) exists in 1457934648 in HTML format HTML  |  1457934648 in plain Text format TXT  |  1457934648 in PDF (Portable Document Format) PDF  |  1457934648 in an XML format XML  formats.

NPI Number : 1457934648 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1457934648",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DELOYA",
    "FirstName": "ELLEN",
    "MiddleName": "J",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DO",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "DOUGLASS",
    "OtherFirstName": "ELLEN",
    "OtherMiddleName": "J",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "DO",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "16899 W BERNARDO DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN DIEGO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92127-1603",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "858-499-2705",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "16899 W BERNARDO DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN DIEGO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92127-1603",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "858-499-2705",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/04/2021",
    "LastUpdateDate": "08/13/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "MRO-2047",
          "LicenseNumberStateCode": "ID",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "O-1753",
          "LicenseNumberStateCode": "ID",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "20A23860",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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