Organization Active NPI

Paredes Medical Corporation

  • Geriatric Medicine (Family Medicine) Physician
  • Coachella, CA
National Provider Identifier
1336918507
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
PAREDES MEDICAL CORPORATION
Practice address
49201 Grapefruit Blvd Ste 3
Coachella, CA 92236-1479
Phone
(760) 514-2269
NPI assigned
Dec 28, 2023
Last updated
Apr 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Dr. Gustavo Adolfo Paredes, MDNPI 1164697173
Title
President
Phone
(760) 972-4704

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X Primary

Addresses

Primary practice location

49201 Grapefruit Blvd Ste 3
Coachella, CA 92236-1479

Mailing address

49201 Grapefruit Blvd Ste 3
Coachella, CA 92236-1479
Phone (760) 972-4704

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240229000137 CA Part B Supplier - Clinic/Group Practice 6901241041 Receives reassigned benefits from 1 practitioner
Practice locations: Coachella, 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
05D2297208Paredes Medical Corporation49201 Grapefruit Blvd Ste 3, Coachella, CA 92236Certificate of waiverJan 10, 2028

National Provider Directory

National Provider Directory

Locations

49201 Grapefruit Blvd
Ste 3
Coachella, CA 92236
Phone (760) 514-2269

Practitioners & affiliated clinicians

Practitioners 3

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": "1703721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1336918507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49201 GRAPEFRUIT BLVD STE 3",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361479",
            "telephone_number": "760-972-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49201 GRAPEFRUIT BLVD STE 3",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361479",
            "telephone_number": "760-514-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAREDES MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-28",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "PAREDES",
        "authorized_official_first_name": "GUSTAVO",
        "authorized_official_middle_name": "ADOLFO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-972-4704",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coachella, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.