Active NPI
Gene Martin Cordova, P.A.
- Physician Assistant
- La Mesa, CA
National Provider Identifier
1447358908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA11871
- Practice address
- 5525 Grossmont Center Dr
La Mesa, CA 91942-3009 - Phone
- (858) 644-6600
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA11871 | CA | Primary |
Addresses
Primary practice location
5525 Grossmont Center Dr
La Mesa, CA 91942-3009
Mailing address
5525 Grossmont Center Dr
La Mesa, CA 91942-3009
Phone (858) 644-6600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sharp Rees-Stealy Medical Group, Inc | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- San Diego, CA
- NPI 1285616177
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447358908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5525 GROSSMONT CENTER DR",
"city": "LA MESA",
"state": "CA",
"postal_code": "919423009",
"telephone_number": "858-644-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5525 GROSSMONT CENTER DR",
"city": "LA MESA",
"state": "CA",
"postal_code": "919423009",
"telephone_number": "858-644-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDOVA",
"first_name": "GENE",
"middle_name": "MARTIN",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA11871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.