John Russell Gorny, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G12635 Issued in CA

Practice address

665 Camino de Los Mares
Suite 203a
San Clemente, CA 92673-2859

Phone

(949) 661-3101

Fax

(949) 661-2865

NPI assigned

Feb 19, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• John R Gorny MD Inc

  • Obstetrics & Gynecology Physician
  • San Clemente, CA
  • NPI 1790945970
  Authorized official Same address or phone

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1104960251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 CAMINO DE LOS MARES",
            "address_2": "SUITE 203A",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732859",
            "telephone_number": "949-661-3101",
            "fax_number": "949-661-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 CAMINO DE LOS MARES",
            "address_2": "SUITE 203A",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732859",
            "telephone_number": "949-661-3101",
            "fax_number": "949-661-2865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORNY",
        "first_name": "JOHN",
        "middle_name": "RUSSELL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G12635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "953607067",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOG126350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chloe Marie Gonzalez
• Valerie Ann Gonzalez, MS, BCBA
• Patricia L. Good, NP
• Beverly Jean Goodman
• Jensen Gorman
• Marilyn Gottdank, MFT
• Maritza Granados, ACSW, PPSC
• Gratias, Inc.
• Greathouse Chiropractic Inc
• Wayne Greathouse, DC

• Obstetrics & Gynecology Physician in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.