Individual provider Active NPI

Gabrielle Pina, D.O.

  • Pediatrics Physician
  • Loma Linda, CA
National Provider Identifier
1285053330
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20A14299 Issued in CA
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(909) 558-4000
NPI assigned
Apr 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 20A14299 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 558-4000

Other practice location 1

16293 Skywood Ct
Moreno Valley, CA 92551-7234
Phone (951) 741-8619

Other names 1

  • Gabrielle Balan Former name

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
I20170920004115 CA Practitioner - Pediatric Medicine 8527332147 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
14299CAMDGeneral Practice Dentistry
20A14299CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Single Specialty Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics CurrentSince Aug 1, 2019 Accepting new patients
Faculty Physicians and Surgeons of Llusm Single Specialty Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Single Specialty Current Accepting new patients
Diagnostic Imaging Services Single Specialty Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients

Locations

7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

26780 Barton Rd
Redlands, CA 92373
Phone (909) 558-5174

Interoperability endpoints

  • Direct secure messaging: gpina72655@direct.llu.edu

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1285053330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16293 Skywood Ct",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925517234",
            "country_code": "US",
            "telephone_number": "951-741-8619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINA",
        "first_name": "GABRIELLE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A14299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GABRIELLE",
            "last_name": "BALAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.