Gustavo a. Machicado M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

G30863 Issued in CA

Legal business name

GUSTAVO A. MACHICADO M.D.

Practice address

18350 Roscoe Blvd.
Suite 303
Northridge, CA 91325-4157

Phone

(818) 885-6261

Fax

(818) 885-5384

NPI assigned

Apr 13, 2007

Organization subpart

No

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

Authorized official

Name

Gustavo A Machicado, M.D.NPI 1568434652

Title

President

Phone

(818) 885-6261

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gustavo A Machicado, MD

  • Gastroenterology Physician
  • Northridge, CA
  • NPI 1568434652
  NPD Authorized official

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551916800000",
    "number": "1376768747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18350 ROSCOE BLVD STE 604",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254190",
            "telephone_number": "818-885-6261",
            "fax_number": "818-885-5384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18350 ROSCOE BLVD.",
            "address_2": "SUITE 303",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254157",
            "telephone_number": "818-885-6261",
            "fax_number": "818-885-5384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUSTAVO A. MACHICADO M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2019-03-07",
        "status": "A",
        "authorized_official_last_name": "MACHICADO",
        "authorized_official_first_name": "GUSTAVO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-885-6261",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G30863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G308630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sanjay K Gupta
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• Carol Gurrola
• Nergis Ariel Gurses, D.M.D.
• Domingo Gutierrez Mejia, BCBA
• Jeniffer Gutierrez-Baca
• Ashly Gutierrez
• Betsy Gutierrez
• Brenda Gutierrez

• Gastroenterology Physician in Northridge, CA
• Providers in Northridge, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.