Organization Active NPI

Care Gastroenterology Medical Group

  • Gastroenterology Physician
  • San Clemente, CA
National Provider Identifier
1003964370
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A60836 Issued in CA
Legal business name
CARE GASTROENTEROLOGY MEDICAL GROUP
Practice address
655 Camino de Los Mares
Sute 123
San Clemente, CA 92673-2809
Phone
(949) 443-1546
Fax
(949) 443-1077
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Navjyot Gujral, MDNPI 1174591994
Title
Physician
Phone
(949) 734-4396

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X A60836 CA Primary

Addresses

Primary practice location

655 Camino de Los Mares
Sute 123
San Clemente, CA 92673-2809

Mailing address

PO Box 4517
Mission Viejo, CA 92690-4517
Phone (949) 443-1546

Other identifiers 1

IdentifierTypeStateIssuer
00A608360MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121221000181 CA Part B Supplier - Clinic/Group Practice 2769634708 Receives reassigned benefits from 1 practitioner
Practice locations: San Clemente, CA

National Provider Directory

National Provider Directory

Locations

655 Camino de los Mares
Ste 123
San Clemente, CA 92673
Phone (949) 443-1546

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1003964370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4517",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926904517",
            "telephone_number": "949-443-1546",
            "fax_number": "949-443-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 CAMINO DE LOS MARES",
            "address_2": "SUTE 123",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732809",
            "telephone_number": "949-443-1546",
            "fax_number": "949-443-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE GASTROENTEROLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "GUJRAL",
        "authorized_official_first_name": "NAVJYOT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "949-734-4396",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A60836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A608360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.