1. Home
  2. Directory
  3. California
  4. Harbor City
  5. Physician Assistant
  6. NPI Profile

EDILITA DE BODA PAC
NPI 1982892956
Physician Assistant - Medical in Harbor City, CA

Active since October 04, 2007PECOS Enrolled
1535 LOMITA BLVD, HARBOR CITY, CA 90710(310) 530-9300 Get Directions Write a Review

NPPES record last updated: May 6, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Edilita De Boda Pac NPPES

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

EDILITA DE BODA PAC (NPI 1982892956) is an individual medical provider in Harbor City, California, licensed in California (PA 15259) and active in the NPI registry since October 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1982892956
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameEDILITA DE BODACredential: PAC
Location Address1535 LOMITA BLVDHarbor City, CA 90710-2024
Mailing Address1535 Lomita BlvdHarbor City, CA 90710-2024 · (310) 530-9300
Phone(310) 530-9300
Sole ProprietorYes
Enumeration DateOctober 4, 2007
Last NPPES UpdateMay 6, 2008
✔ NPI 1982892956 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in CA · PA 15259
1535 LOMITA BLVD, Harbor City, CA 90710
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edilita De Boda Pac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ST. ISABEL FAMILY MEDICAL CLINIC, INC.
Clinic/Center (Primary Care)
1535 LOMITA BLVD
HARBOR CITY, CA 90710
Los Angeles County (310) 530-9300

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 Edilita De Boda's NPI number?

The NPI number for Edilita De Boda is 1982892956. It was assigned to this individual provider in the NPPES registry on October 4, 2007.

Where is Edilita De Boda located?

Edilita De Boda practices at 1535 Lomita Blvd, Harbor City, CA 90710. The listed phone number is (310) 530-9300.

What is Edilita De Boda's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Edilita De Boda enrolled in Medicare?

Yes. Edilita De Boda is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Edilita De Boda was last updated on May 6, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.