Physician Associates of the Greater San Gabiel Valley, a Medical Group

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

PHYSICIAN ASSOCIATES OF THE GREATER SAN GABIEL VALLEY, A MEDICAL GROUP

Practice address

199 S Los Robles Ave
Suite 300
Pasadena, CA 91101-2452

Phone

(626) 817-8300

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Barton Wald, MD

Title

Ceo

Phone

(626) 817-8313

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457423790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 S LOS ROBLES AVE",
            "address_2": "SUITE 300",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012452",
            "telephone_number": "626-817-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 S LOS ROBLES AVE",
            "address_2": "SUITE 300",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012452",
            "telephone_number": "626-817-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN ASSOCIATES OF THE GREATER SAN GABIEL VALLEY, A MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALD",
        "authorized_official_first_name": "BARTON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-817-8313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.