Individual provider Active NPI

Yolanda P Gomez, MD

  • Internal Medicine Physician
  • Rancho Santa Margarita, CA
National Provider Identifier
1306842877
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C50624 Issued in CA
Practice address
22342 Avenida Empresa
Suite 195
Rancho Santa Margarita, CA 92688-2140
Phone
(949) 713-9705
Fax
(949) 858-3826
NPI assigned
Jun 21, 2005
Reactivated
Nov 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C50624 CA Primary

Addresses

Primary practice location

22342 Avenida Empresa
Suite 195
Rancho Santa Margarita, CA 92688-2140

Mailing address

22342 Avenida Empresa
Suite 195
Rancho Santa Margarita, CA 92688-2140
Phone (949) 713-9705

Other identifiers 1

IdentifierTypeStateIssuer
C50624OtherCASTATE LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50624CAMDPharmacist
C50624CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ross Medical Associates Past Accepting new patients

Organizations & group practices 1

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1306842877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22342 AVENIDA EMPRESA",
            "address_2": "SUITE 195",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882140",
            "telephone_number": "949-713-9705",
            "fax_number": "949-858-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22342 AVENIDA EMPRESA",
            "address_2": "SUITE 195",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882140",
            "telephone_number": "949-713-9705",
            "fax_number": "949-858-3826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "YOLANDA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2012-06-29",
        "deactivation_date": "2005-12-19",
        "reactivation_date": "2006-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C50624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC",
            "identifier": "C50624",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.