Individual provider Active NPI

Gerardo William Hizon, MD, FAAFP, CAQSM

  • Family Medicine Physician
  • Temecula, CA
National Provider Identifier
1205898558
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G55359 Issued in CA
Practice address
27699 Jefferson Ave Ste 101
Temecula, CA 92590-2696
Phone
(951) 790-0107
Fax
(951) 667-1933
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X G55359 CA
Family Medicine Physician 207Q00000X G55359 CA Primary

Addresses

Primary practice location

27699 Jefferson Ave Ste 101
Temecula, CA 92590-2696

Mailing address

27699 Jefferson Ave Ste 101
Temecula, CA 92590-2696
Phone (951) 790-0107

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120608000503 CA Practitioner - Family PracticePractitioner - Sports Medicine 3678467008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rancho Family Medical Group IncGroup PAC ID 6305741240, 112 clinicians

Practice addresses (Care Compare)

28780 Single Oak Dr
Suite 270
Temecula, CA 92590-5534
Phone (951) 676-4193

Hospital & facility affiliations

  • Mission Home Health of San Diego LLC Home health agency, San Diego, CA, CCN 557711
  • Angelicare Home Health Inc Home health agency, Chino, CA, CCN 059316

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
G55359CAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rancho Family Medical Group, Inc. Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Hizon Medical Corporation Past Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients

Locations

263 Church Ave
Chula Vista, CA 91910
Phone (619) 422-1324

28780 Single Oak Dr
Ste 160
Temecula, CA 92590
Phone (951) 658-9461

28780 Single Oak Dr
Ste 270
Temecula, CA 92590
Phone (951) 600-1795

27450 Ynez Rd
Ste 128
Temecula, CA 92591
Phone (714) 935-0073

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 2

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1205898558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27699 JEFFERSON AVE STE 101",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902696",
            "telephone_number": "951-790-0107",
            "fax_number": "951-667-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27699 JEFFERSON AVE STE 101",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902696",
            "telephone_number": "951-790-0107",
            "fax_number": "951-667-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIZON",
        "first_name": "GERARDO",
        "middle_name": "WILLIAM",
        "credential": "MD, FAAFP, CAQSM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "G55359",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G55359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.