Individual provider Active NPI

Gino Pineda

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1366220329
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA66432 Issued in CA
Practice address
2080 Century Park E Ste 1005
Los Angeles, CA 90067-2013
Phone
(951) 514-9905
NPI assigned
Sep 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA66432 CA Primary

Addresses

Primary practice location

2080 Century Park E Ste 1005
Los Angeles, CA 90067-2013

Mailing address

1265 Welch Rd Ste 100
Stanford, CA 94305-5102

Other practice location 1

1265 Welch Rd Ste 100
Stanford, CA 94305-5102
Phone (650) 725-6959

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
I20251031002273 CA Practitioner - Physician Assistant 9436648102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2080 Century Park E
Suite 1005
Los Angeles, CA 90067-2013
Phone (310) 229-3555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA66432CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles Hematology-Oncology Medical Group Current Accepting new patients
Los Angeles Hematology-Oncology Medical Group CurrentSince Sep 1, 2025 Accepting new patients
Los Angeles Cardiology Associates Past Accepting new patients

Locations

1211 W La Palma Ave
Ste 103
Anaheim, CA 92801
Phone (714) 535-3660

260 E Ontario Ave
Ste 101
Corona, CA 92879
Phone (951) 268-7746

1505 Wilson Ter
Ste 200
Glendale, CA 91206
Phone (818) 243-0477

1245 Wilshire Blvd
Ste 303
Los Angeles, CA 90017
Phone (213) 977-1214

2080 Century Park E
Ste 1005
Los Angeles, CA 90067
Phone (310) 229-3535

15211 Vanowen St
Ste 201
Van Nuys, CA 91405
Phone (818) 574-3798

Organizations & group practices 3

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": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1366220329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 WELCH RD STE 100",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK E STE 1005",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672013",
            "telephone_number": "951-514-9905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1265 Welch Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "CA",
            "postal_code": "943055102",
            "country_code": "US",
            "telephone_number": "650-725-6959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINEDA",
        "first_name": "GINO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-20",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA66432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.