Individual provider Active NPI

Gladys Hope Dadivas Yerro, MD

  • Pediatric Adolescent Medicine Physician
  • Van Nuys, CA
National Provider Identifier
1053676619
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
A48553 Issued in CA
Practice address
14555 Hamlin St Ste 108
Van Nuys, CA 91411-1617
Phone
(818) 781-2796
Fax
(818) 781-2797
NPI assigned
Jul 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X A48553 CA Primary

Addresses

Primary practice location

14555 Hamlin St Ste 108
Van Nuys, CA 91411-1617

Mailing address

14555 Hamlin St Ste 108
Van Nuys, CA 91411-1617
Phone (818) 781-2796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A48553CAMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Presbyterian Hospital Past Accepting new patients
G. Hope D. Yerro. MD,Inc Adolescent Medicine Past Accepting new patients
Malkhas Medical Group Inc PastSince Feb 9, 2020 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1053676619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14555 HAMLIN ST STE 108",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111617",
            "telephone_number": "818-781-2796",
            "fax_number": "818-781-2797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14555 HAMLIN ST STE 108",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111617",
            "telephone_number": "818-781-2796",
            "fax_number": "818-781-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YERRO",
        "first_name": "GLADYS HOPE",
        "middle_name": "DADIVAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "A48553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.