NPIMap

Organization Active NPI

La Jolla Gastroenterology Medical Group, Inc

  • Specialist
  • La Jolla, CA
National Provider Identifier
1457397465
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
LA JOLLA GASTROENTEROLOGY MEDICAL GROUP, INC
Practice address
9850 Genesee Ave Ste 770
La Jolla, CA 92037-1232
Phone
(858) 453-5200
Fax
(858) 453-5160
NPI assigned
Jun 20, 2006
Last updated
Dec 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Authorized official

Name
Dr. Edward Cruz Paredez, M.D.NPI 1518951714
Title
President
Phone
(858) 453-5200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

9850 Genesee Ave Ste 770
La Jolla, CA 92037-1232

Mailing address

9850 Genesee Ave Ste 770
La Jolla, CA 92037-1232
Phone (858) 453-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101004000336 CA Part B Supplier - Clinic/Group Practice 7810925096 Receives reassigned benefits from 7 practitioners
Practice locations: La Jolla, CA

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

1745 S Imperial Ave
#112
El Centro, CA 92243
Phone (619) 453-5200

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 & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764720000000",
    "number": "1457397465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE STE 770",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371232",
            "telephone_number": "858-453-5200",
            "fax_number": "858-453-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE STE 770",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371232",
            "telephone_number": "858-453-5200",
            "fax_number": "858-453-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA JOLLA GASTROENTEROLOGY MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A",
        "authorized_official_last_name": "PAREDEZ",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "CRUZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-453-5200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.