Edgardo Gonzalez, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G53693 Issued in CA

Practice address

6301 Beach Blvd
Suite 101
Buena Park, CA 90621-2840

Phone

(714) 994-5290

Fax

(714) 994-8090

NPI assigned

Nov 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: General Practice

Education

University of California, Geffen School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Buena Park Medical GroupGroup PAC ID 9335191063, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Buena Park Medical Group

  • Family Medicine Physician
  • Buena Park, CA
  • NPI 1477625671

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Anaheim Memorial Medical Center

  • General Acute Care Hospital
  • Anaheim, CA
  • NPI 1295782381
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1366514655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906210277",
            "telephone_number": "714-994-5290",
            "fax_number": "714-994-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 BEACH BLVD",
            "address_2": "SUITE 101",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212840",
            "telephone_number": "714-994-5290",
            "fax_number": "714-994-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "EDGARDO",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G53693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G536930",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0099930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chad Wesley Goche I
• Maria Elena Gomez, RN
• Susana Gomez, OTR/L
• Richard Gonzales, MD
• Bernarda Brenda Gonzalez
• Goodman Maa DDS
• Claire Goodman, RN
• Bahram Goshtasbi, D.C.
• Grace Medical Ipa
• Greater Anaheim Special Education Local Plan Area

• Internal Medicine Physician in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.