Alberto Gedissman, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A26326 Issued in CA

Practice address

1515 S Broadway
Suite a
Santa Ana, CA 92707-2253

Phone

(714) 919-0280

Fax

(714) 288-8970

NPI assigned

Oct 13, 2005

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

Other identifiers 1

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

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320624000000",
    "number": "1104814086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3141 MICHELSON DR",
            "address_2": "APT 1404",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926125623",
            "telephone_number": "714-425-4319",
            "fax_number": "949-854-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 S BROADWAY",
            "address_2": "SUITE A",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927072253",
            "telephone_number": "714-919-0280",
            "fax_number": "714-288-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEDISSMAN",
        "first_name": "ALBERTO",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2011-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A26326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A263260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Geeta Seth DDS, Inc
• Alexis Geibler
• Geiss Med Hospice LLC
• John Mark Geiss, D.O.
• Symone Betty Gelay

• Pediatrics Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; 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.