Individual provider Active NPI

Daniel Gonzalez, PA-C

  • Surgical Physician Assistant
  • Pomona, CA
National Provider Identifier
1144920612
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
62444 Issued in CA
Practice address
255 E Bonita Ave Unit 9
Pomona, CA 91767-1923
Phone
(909) 301-8897
NPI assigned
Mar 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 62444 CA
Surgical Physician Assistant 363AS0400X 62444 CA Primary

Addresses

Primary practice location

255 E Bonita Ave Unit 9
Pomona, CA 91767-1923

Mailing address

782 Oak Ave
Pomona, CA 91766-2635
Phone (909) 282-7779

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230601000373 CA Practitioner - Physician Assistant 0547627853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Loma Linda University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1115 S Sunset Ave
West Covina, CA 91790-3940
Phone (626) 962-4011

1211 W 6TH St
Ontario, CA 91762-1103
Phone (909) 933-6580

1798 N Garey Ave
Pomona, CA 91767-2918
Phone (909) 865-9500

255 E Bonita Ave
Pomona, CA 91767-1923
Phone (909) 593-3550

6216 Brockton Ave
Suite 213
Riverside, CA 92506-2223
Phone (909) 450-0369

995 San Bernardino Rd
Upland, CA 91786-4920
Phone (909) 579-1500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
62444CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Scott C Lederhaus MD & Lew B Disney MD PRT Lederhaus Scott C Gen PTR Past Accepting new patients

Locations

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

255 E Bonita Ave
Bldg 9
Pomona, CA 91767
Phone (909) 450-0369

255 E Bonita Ave
Unit 9
Pomona, CA 91767
Phone (909) 301-8897

255 E Bonita Ave
Ste 9
Pomona, CA 91767

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 3

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 7

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": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1144920612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "782 OAK AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662635",
            "telephone_number": "909-282-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E BONITA AVE UNIT 9",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671923",
            "telephone_number": "909-301-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "62444",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "62444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.