NPIMap

Individual provider Active NPI

Marisa C Gonzalez, M.D.

  • Obstetrics & Gynecology Physician
  • San Diego, CA
National Provider Identifier
1083870463
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A120499 Issued in CA
Practice address
1809 National Ave
San Diego, CA 92113
Phone
(619) 515-2300
Fax
(619) 269-0674
NPI assigned
Aug 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A120499 CA Primary

Addresses

Primary practice location

1809 National Ave
San Diego, CA 92113

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

Other practice location 1

655 Euclid Ave
Suite 409
National City, CA 91950-2957
Phone (619) 267-8313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180124002621 CA Practitioner - Obstetrics/Gynecology 1254690035 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Harvard Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

10862 Calle Verde
La Mesa, CA 91941-7340
Phone (619) 670-5400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A120499CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health CurrentSince Feb 3, 2020 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Sep 25, 2018 Accepting new patients
Scripps Health Current Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Scripps Health Obstetrics & Gynecology Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Sep 25, 2018 Accepting new patients
Scripps Health Obstetrics & Gynecology CurrentSince Feb 3, 2020 Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients
South Bay OBGYN PastSince Jan 1, 2023 Accepting new patients
Scripps Health Past Accepting new patients
Sharp Chula Vista Medical Center Past Accepting new patients
South Bay OB/GYN Medical Group, Inc. Past Accepting new patients

Locations

971 Lane Ave
Chula Vista, CA 91914
Phone (619) 472-1000

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

10862 Calle Verde
La Mesa, CA 91941
Phone (619) 660-5400

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

Interoperability endpoints

  • Direct secure messaging: mgonzalez201548@scrippshlth.medalliesdirect.net

Organizations & group practices 12

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1083870463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300",
            "fax_number": "619-269-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 NATIONAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92113",
            "telephone_number": "619-515-2300",
            "fax_number": "619-269-0674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 Euclid Ave",
            "address_2": "Suite 409",
            "address_purpose": "LOCATION",
            "city": "National City",
            "state": "CA",
            "postal_code": "919502957",
            "country_code": "US",
            "telephone_number": "619-267-8313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARISA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A120499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.