Active NPI
William Gomez, P.A.
- Physician Assistant
- Maywood, CA
National Provider Identifier
1144382102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA11139
- Practice address
- 5953 Atlantic Blvd
Maywood, CA 90270-3133 - Phone
- (323) 562-6170
- Fax
- (323) 562-6176
- NPI assigned
- Dec 15, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA11139 | CA | Primary |
Addresses
Primary practice location
5953 Atlantic Blvd
Maywood, CA 90270-3133
Mailing address
5953 Atlantic Blvd
Maywood, CA 90270-3133
Phone (323) 562-6170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA11139 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144382102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5953 ATLANTIC BLVD",
"city": "MAYWOOD",
"state": "CA",
"postal_code": "902703133",
"telephone_number": "323-562-6170",
"fax_number": "323-562-6176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5953 ATLANTIC BLVD",
"city": "MAYWOOD",
"state": "CA",
"postal_code": "902703133",
"telephone_number": "323-562-6170",
"fax_number": "323-562-6176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "WILLIAM",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA11139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maywood, CA
- Functional Restoration Medical Center, Inc, (Maywood Open MRI)
- Ileana Garcia
- Ruth Jennifer Garcia, MS SPED MILD/MOD
- Edwin Garduno
- Gary Garoian D.D.S., Inc. (Summer Dental Group)
- Casey Lynn Green, OTR/L
- Rafiael Grigorian
- Jesse Ignacio Guerrero
- Aaron Hakakian, DDS
- Health Access for All, Inc (Angeles Community Health Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.