Gregory K. Suelzle, M.D., a Medical Corporation

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

G77184 Issued in CA

Legal business name

GREGORY K. SUELZLE, M.D., A MEDICAL CORPORATION

Practice address

1330 San Bernardino Rd
Suite B
Upland, CA 91786-4928

Phone

(909) 981-0608

Fax

(866) 695-1267

NPI assigned

Aug 13, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Gregory K. Suelzle, M.D.NPI 1326016023

Title

Owner

Phone

(909) 981-0608

Specialties & licenses 2

Addresses

Other names 1

• Upland Grove Medical Group Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

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

• Gregory Kenneth Suelzle, MD

  • Interventional Pain Medicine Physician
  • Upland, CA
  • NPI 1326016023
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398038400000",
    "number": "1386890044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 SAN BERNARDINO RD",
            "address_2": "SUITE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864928",
            "telephone_number": "909-981-0608",
            "fax_number": "866-695-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 SAN BERNARDINO RD",
            "address_2": "SUITE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864928",
            "telephone_number": "909-981-0608",
            "fax_number": "866-695-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY K. SUELZLE, M.D., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2014-04-21",
        "status": "A",
        "authorized_official_last_name": "SUELZLE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-981-0608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G78385",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "G77184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upland Grove Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Gray, D.D.S., M.S.
• Richard James Gray, O.D.
• Chevaughn Ronee Green
• Shalla Green
• John P Greenwood, DDS
• Chelsea Grenfell
• Carissa Ninez Alberto Grepo
• Anne Christine Griffith, CD(DONA)
• Grigoryan Professional Dental Corp
• Vahan Grigoryan, DDS

• Interventional Pain Medicine Physician in Upland, CA
• Providers in Upland, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.