Generoso S Nery M D Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A31007 Issued in CA

Legal business name

GENEROSO S NERY M D INC

Practice address

1183 E Foothill Blvd
Suite 135
Upland, CA 91786-4079

Phone

(909) 931-1368

Fax

(909) 931-1372

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Generoso Santos Nery, MD

Title

President

Phone

(909) 931-1368

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1164500559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1183 E FOOTHILL BLVD",
            "address_2": "SUITE 135",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864079",
            "telephone_number": "909-931-1368",
            "fax_number": "909-931-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1183 E FOOTHILL BLVD",
            "address_2": "SUITE 135",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864079",
            "telephone_number": "909-931-1368",
            "fax_number": "909-931-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENEROSO S NERY M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "NERY",
        "authorized_official_first_name": "GENEROSO",
        "authorized_official_middle_name": "SANTOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-931-1368",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A31007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A310070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Upland, CA
• Providers in Upland, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.