Dory Llamado Gomer

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95022234 Issued in CA

Practice address

1800 Western Ave Ste 103
San Bernardino, CA 92411-1352

Phone

(909) 802-9374

NPI assigned

Apr 11, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Wilson Gomer M.D. Professional Medical Corporation

  • Health Service Clinic/Center
  • San Bernardino, CA
  • NPI 1104327543
  NPD

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682121600000",
    "number": "1346936671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11882 SANDRA CT",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923546759",
            "telephone_number": "909-802-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 WESTERN AVE STE 103",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111352",
            "telephone_number": "909-802-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMER",
        "first_name": "DORY",
        "middle_name": "LLAMADO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-04-22",
        "certification_date": "2023-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95022234",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95022234",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95022234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Golden Medical Services
• Golden Valley Medical & Oxygen Service
• Goldencrest Primary Care
• Amir Hossen Golsorkhi, MD
• Samantha Golucino
• Wilson Gomer, MD
• Christian Uriel Gomez Soberanis
• Adan Carlos Gomez, ASW
• Adriana Gomez
• Alena M Gomez

• Nurse Practitioner in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2023; 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.