Individual provider Active NPI

Quimbo Gulay Ching, MD

  • Pediatrics Physician
  • Indio, CA
National Provider Identifier
1083667646
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C134912 Issued in CA
Practice address
81833 Dr Carreon Blvd Ste 6
Indio, CA 92201-5590
Phone
(760) 775-7763
Fax
(760) 775-9953
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-068065 IL
Pediatrics Physician 208000000X C134912 CA Primary

Addresses

Primary practice location

81833 Dr Carreon Blvd Ste 6
Indio, CA 92201-5590

Mailing address

81833 Dr Carreon Blvd Ste 6
Indio, CA 92201-5590
Phone (760) 775-7763

Other practice location 1

825 S Milwaukee Ave
Libertyville, IL 60048-3218
Phone (847) 680-8066

Other identifiers 1

IdentifierTypeStateIssuer
367830OtherILPEDIATRICS

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL AMG Other

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C134912CAMDPediatrics Physician
036-068065ILMDPediatrics Physician

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Yazji Pediatric Care, a Medical Corporation Pediatrics PastSince Jan 17, 2021 Accepting new patients
JFK Memorial Hospital, Inc. Past Accepting new patients
Zosima B. Carino-Gateb, M.D., Inc. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: quimbo.ching.p48@direct.mydohc.nextgenshare.com

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1083667646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81833 DR CARREON BLVD STE 6",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015590",
            "telephone_number": "760-775-7763",
            "fax_number": "760-775-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81833 DR CARREON BLVD STE 6",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015590",
            "telephone_number": "760-775-7763",
            "fax_number": "760-775-9953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 S Milwaukee Ave",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600483218",
            "country_code": "US",
            "telephone_number": "847-680-8066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHING",
        "first_name": "QUIMBO",
        "middle_name": "GULAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-068065",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C134912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDIATRICS",
            "identifier": "367830",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "AMG",
            "affiliation": "N",
            "endpointDescription": "Peidatrics",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Direct mail",
            "address_1": "825 S Milwaukee Ave",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600483218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.