NPIMap

Individual provider Active NPI

Jacqueline Nicole Mariano Gallardo, MD

  • Family Medicine Physician
  • Seal Beach, CA
National Provider Identifier
1134611882
Registry record updated Nov 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A173639 Issued in CA
Practice address
1198 Pacific Coast Hwy # 1
Seal Beach, CA 90740-6251
Phone
(562) 799-7071
Fax
(562) 594-5627
NPI assigned
May 30, 2018
Last updated
Nov 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A173639 CA Primary

Addresses

Primary practice location

1198 Pacific Coast Hwy # 1
Seal Beach, CA 90740-6251

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

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
I20210730002030 CA Practitioner - Family Practice 3678810652 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centers for Family Medicine GPGroup PAC ID 9931143799, 87 clinicians

Practice addresses (Care Compare)

1198 Pacific Coast Hwy
Suite I
Seal Beach, CA 90740-6248
Phone (562) 799-7071

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A173639CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cassidy Medical Group Inc. Current Accepting new patients
Centers for Family Medicine GP Family Medicine CurrentSince Dec 1, 2024 Accepting new patients
Beaver Medical Group P C Family Medicine Current Accepting new patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince Sep 1, 2025 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Sep 1, 2025 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
UC Regents PastSince Jul 1, 2021 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

4910 Airport Plaza Dr
Ste 210
Long Beach, CA 90815
Phone (562) 421-3727

3460 Katella Ave
Los Alamitos, CA 90720
Phone (310) 594-6599

1198 Pacific Coast Hwy
Ste I
Seal Beach, CA 90740
Phone (562) 799-7071

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

145 Thunder Dr
Vista, CA 92083
Phone (760) 630-5487

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jaqueline.gallardo.p33@direct.monarchhealthcare.nextgenshare.com
  • Direct secure messaging: jgallardo204613@westdirect.optum.com

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763251200000",
    "number": "1134611882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1198 PACIFIC COAST HWY # 1",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907406251",
            "telephone_number": "562-799-7071",
            "fax_number": "562-594-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLARDO",
        "first_name": "JACQUELINE NICOLE",
        "middle_name": "MARIANO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-30",
        "last_updated": "2025-11-16",
        "certification_date": "2025-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A173639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seal Beach, CA

Sources for this page

Verify at the official NPI Registry.