Kelvis Gonzalez Gallardo, M.D.
Individual provider Active NPI Family Medicine Physician · Avenal, CA
NPI 1215399639 · NPPES record last updated Apr 9, 2024
Key facts
- NPI
- 1215399639
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A157046 (CA)
- Practice address
- 148 E Kings St
Avenal, CA 93204-1529 - Phone
- (559) 386-9000
- Fax
- (559) 386-9090
- NPI assigned
- Mar 24, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250602000919 | CA | Order and Referring Only - Family Practice |
7214274323 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A157046 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aria Community Health Center | Past |
Accepting new patients | |
| Aria Community Health Center | Past |
Accepting new patients | |
| Aria Community Health Center | Past | Accepting new patients | |
| Kaweah Delta Health Care District | Past | Accepting new patients |
Interoperability endpoints
- kelvis.gonzalezgallardo.p1@direct.altura.nextgenshare.com
- kelvis.gonzalezgallardo.p1@direct.ariachc.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A157046 | CA | Yes |
Addresses
Primary practice location
148 E Kings St
Avenal, CA 93204-1529
Mailing address
PO Box 580
Lemoore, CA 93245-0580
Phone (559) 386-4500
Other practice location 1
329 W 8th St Ste 111
Hanford, CA 93230-4533
Phone (559) 582-2500
Other practice location 2
329 W 8th St Ste 109
Hanford, CA 93230-4533
Phone (559) 582-2500
Other providers in Avenal, CA
- Elaine Greeley Force
- Tina Garcia
- Maria Antoinette Gomes
- Ruby Gomez
- Amanda Joyce Gonzales
- Cinthia Gonzalez Marmolejo
- Junior Gonzalez
- Kavin Gustafson
- Hassan Saad Ismael
- Shalini Monica Kabeer
All providers in Avenal, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.