Edgar a. Gamboa, M.D. Medical Corp

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

C41857 Issued in CA

Legal business name

EDGAR A. GAMBOA, M.D. MEDICAL CORP

Practice address

243 Green Valley Rd
Ste. D
Freedom, CA 95019-3133

Phone

(831) 724-7874

Fax

(831) 724-4339

NPI assigned

Mar 25, 2008

Last updated

May 18, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edgar A Gamboa, MDNPI 1265508980

Title

Owner

Phone

(831) 724-7874

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17898/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edgar Gamboa, MD

  • Surgery Physician
  • Freedom, CA
  • NPI 1265508980
  Authorized official Same address or phone
• Melissa Lopez-Bermejo, MD

  • Pulmonary Disease Physician
  • Freedom, CA
  • NPI 1548360084
  NPD (past)
• Siddharth Ved Malhotra, M.D.

  • Specialist
  • Hamlet, NC
  • NPI 1790004950

  Surgery

  NPD (past)

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1063684561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 GREEN VALLEY RD",
            "address_2": "STE. D",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "950193133",
            "telephone_number": "831-724-7874",
            "fax_number": "831-724-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 GREEN VALLEY RD",
            "address_2": "STE. D",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "950193133",
            "telephone_number": "831-724-7874",
            "fax_number": "831-724-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGAR A. GAMBOA, M.D. MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "GAMBOA",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "831-724-7874",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C41857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C418570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georgia Nicole Difiore, PHARM.D.
• Digestive Care, LLC
• Ai-Huong DO, PHARM D
• Douglas a Liddicoat Inc
• Hai Phu Duong, PHARM D
• Edward T Bradbury MD a Professional Corporation
• Brandon Erickson, DDS
• Fastrackmed Urgent Care Inc
• Frederick W.K. Chen
• Freedom Acupuncture and Integrative Medicine

• Surgery Physician in Freedom, CA
• Providers in Freedom, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.