Individual provider Active NPI

Dev Appannagari Gnanadev, MD

  • Surgery Physician
  • Colton, CA
National Provider Identifier
1104933985
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
00A357430 Issued in CA
Practice address
400 N Pepper Ave
Armc Modular # 3
Colton, CA 92324-1801
Phone
(909) 580-6210
Fax
(909) 580-1363
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 00A357430 CA
Surgical Critical Care Physician 2086S0102X 00A357430 CA
Surgery Physician 208600000X 00A357430 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Armc Modular # 3
Colton, CA 92324-1801

Mailing address

PO Box 670
Redlands, CA 92373-0221
Phone (909) 580-6210

Other identifiers 1

IdentifierTypeStateIssuer
GR0079700MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090209000619 CA Practitioner - General SurgeryPractitioner - Vascular Surgery 2769395664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cal Med Physicians and Surgeons IncGroup PAC ID 4385556687, 34 clinicians

Practice addresses (Care Compare)

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-3353

Hospital & facility affiliations

  • Arrowhead Regional Medical Center Hospital, Colton, CA, CCN 050245

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35743CAMDOptometrist
00A357430CAMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cal Med Physicians and Surgeons, Inc. Surgery CurrentSince Apr 11, 1997 Accepting new patients
California University of Science and Medicine PastSince Apr 13, 2014 Accepting new patients
Cal Med Endoscopy Center LLC PastSince Jul 23, 2018 Accepting new patients
Cal Med Vascular Center LLC PastSince Jan 1, 2018 Accepting new patients
Cal Med Vascular ASC LLC PastSince Jun 6, 2022 Accepting new patients

Locations

400 N Pepper Ave
#3
Colton, CA 92324
Phone (909) 580-3353

400 N Pepper Ave
Ste 308
Colton, CA 92324
Phone (909) 580-1366

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dgnanadev17828@armc.direct.summit-healthcare.org

Organizations & group practices 5

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1104933985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923730221",
            "telephone_number": "909-580-6210",
            "fax_number": "909-580-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "ARMC MODULAR # 3",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-6210",
            "fax_number": "909-580-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GNANADEV",
        "first_name": "DEV",
        "middle_name": "APPANNAGARI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "00A357430",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CA",
            "license": "00A357430",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "00A357430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0079700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.