Individual provider Active NPI

Gil Symoun B Saura

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Ana, CA
National Provider Identifier
1366064842
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95028172 Issued in CA
Practice address
405 W 5TH St
Santa Ana, CA 92701-4599
Phone
(714) 552-4900
NPI assigned
May 7, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 95181496 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95028172 CA Primary

Addresses

Primary practice location

405 W 5TH St
Santa Ana, CA 92701-4599

Mailing address

5329 E Bergh Dr
Anaheim, CA 92807-3136
Phone (714) 300-9285

Other practice location 1

550 N Flower St
Santa Ana, CA 92703-2361
Phone (714) 647-4666

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241213003375 CA Practitioner - Nurse Practitioner 9830625839 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95181496CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Renewed Medical Group, a Professional Medical Corporation Single Specialty CurrentSince Nov 1, 2024 Accepting new patients
Mental Health and Nursing PC Single Specialty CurrentSince Nov 1, 2024 Accepting new patients

Locations

421 N Brookhurst St
Ste 119
Anaheim, CA 92801
Phone (714) 253-6570

4276 Katella Ave
Los Alamitos, CA 90720

1131 W 6th St
Ste 232
Ontario, CA 91762
Phone (714) 361-0898

Organizations & group practices 2

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": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1366064842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5329 E BERGH DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928073136",
            "telephone_number": "714-300-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W 5TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014599",
            "telephone_number": "714-552-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 N Flower St",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927032361",
            "country_code": "US",
            "telephone_number": "714-647-4666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAURA",
        "first_name": "GIL SYMOUN",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-07",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95181496",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95028172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.