NPIMap

Organization Active NPI

San Bernardino Gastroenterology Associates Inc.

  • Gastroenterology Physician
  • Redlands, CA
National Provider Identifier
1265982375
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A447160
Legal business name
SAN BERNARDINO GASTROENTEROLOGY ASSOCIATES INC.
Practice address
375 Terracina Blvd
Redlands, CA 92373-3801
Phone
(909) 644-4063
Fax
(909) 335-1911
NPI assigned
Oct 12, 2016
Last updated
May 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Authorized official

Name
Kumararvelu Balasubramaniam, M.D.
Title
Owner
Phone
(909) 881-3032

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A447160 Primary

Addresses

Primary practice location

375 Terracina Blvd
Redlands, CA 92373-3801

Mailing address

2006 N Riverside Ave
Ste B
Rialto, CA 92377-4696
Phone (909) 881-3032

Other practice location 1

2006 N Riverside Ave
Ste B
Rialto, CA 92377-4696
Phone (909) 881-3032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161221000716 CA Part B Supplier - Clinic/Group Practice 7214218726 Receives reassigned benefits from 11 practitioners
Practice locations: Redlands, CA; Rialto, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2170603San Bernardino Gastroenterology2006 N Riverside Ave, Ste C, Rialto, CA 92377ComplianceOct 13, 2026

National Provider Directory

National Provider Directory

Locations

10801 Foothill Blvd
#116
Rancho Cucamonga, CA 91730

10801 Foothill Blvd
Ste 106
Rch Cucamonga, CA 91730
Phone (909) 255-7200

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777852800000",
    "number": "1265982375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 N RIVERSIDE AVE",
            "address_2": "STE B",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923774696",
            "telephone_number": "909-881-3032",
            "fax_number": "909-881-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 TERRACINA BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923733801",
            "telephone_number": "909-644-4063",
            "fax_number": "909-335-1911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2006 N Riverside Ave",
            "address_2": "STE B",
            "address_purpose": "LOCATION",
            "city": "Rialto",
            "state": "CA",
            "postal_code": "923774696",
            "country_code": "US",
            "telephone_number": "909-881-3032",
            "fax_number": "909-881-0668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SAN BERNARDINO GASTROENTEROLOGY ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A",
        "authorized_official_last_name": "BALASUBRAMANIAM",
        "authorized_official_first_name": "KUMARARVELU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-881-3032",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": "A447160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.