Jose Dalio Berganza, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A45608 Issued in CA

Practice address

14514 Ramona Blvd
Suite 3
Baldwin Park, CA 91706-3305

Phone

(626) 337-0424

Fax

(626) 813-9095

NPI assigned

Oct 18, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jose D Berganza, M.D Inc

  dba San Jose Muiltispecialty Medical Group,Inc

  • Family Medicine Physician
  • Baldwin Park, CA
  • NPI 1962560896
  Medicare reassignment Authorized official
• Emanate Health Medical Care Foundation

  • Multi-Specialty Clinic/Center
  • West Covina, CA
  • NPI 1467195073
  NPD
• Emanate Health Medical Center

  dba Citrus Valley Medical Center Queen Of the Valley Campus

  • General Acute Care Hospital
  • West Covina, CA
  • NPI 1063441293
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003997032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14514 RAMONA BLVD",
            "address_2": "SUITE 3",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063305",
            "telephone_number": "626-337-0424",
            "fax_number": "626-813-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14514 RAMONA BLVD",
            "address_2": "SUITE 3",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063305",
            "telephone_number": "626-337-0424",
            "fax_number": "626-813-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGANZA",
        "first_name": "JOSE",
        "middle_name": "DALIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A45608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beachwood Medical Supply Inc (Beachwood Medical Supply)
• Rita Bedrossian, MD
• Manie Beheshti, M.D.
• Jennifer Lynn Benedict, M.D.
• Veralyn Benitez
• Aman Berhane, PA-C
• Big 8 Pharmacy Inc (Big 8 Pharmacy)
• John M. Bigley, MD
• Joyce Mary Bitar, MD
• Sumner L Blanchard, SP

• Pediatrics Physician in Baldwin Park, CA
• Providers in Baldwin Park, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.