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ETINOSA LOPEZ EBAGUA
NPI 1700655701
Physician Assistant - Surgical in Santa Maria, CA

Active since January 01, 2024
1075 W BETTERAVIA RD, SANTA MARIA, CA 93455(805) 621-7651 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Sep 11, 2025, Jan 1, 2024 (2 updates tracked since 2024).

About Etinosa Lopez Ebagua NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETINOSA LOPEZ EBAGUA (NPI 1700655701) is an individual surgical provider in Santa Maria, California and active in the NPI registry since January 2024.

NPPES Registry Identity

NPI1700655701
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameETINOSA LOPEZ EBAGUA
Location Address1075 W BETTERAVIA RDSanta Maria, CA 93455
Mailing Address2369 Pizzaro DrSanta Maria, CA 93455-1550 · (818) 350-9140
Phone(805) 621-7651
Sole ProprietorNo
Enumeration DateJanuary 1, 2024
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 1, 2024
✔ NPI 1700655701 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Etinosa Ebagua's NPI number?

The NPI number for Etinosa Ebagua is 1700655701. It was assigned to this individual provider in the NPPES registry on January 1, 2024.

Where is Etinosa Ebagua located?

Etinosa Ebagua practices at 1075 W Betteravia Rd, Santa Maria, CA 93455. The listed phone number is (805) 621-7651.

What is Etinosa Ebagua's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Etinosa Ebagua was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.