De Anza Obstetrics and Gynecology Medical Group, Inc.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A38671 Issued in CA

Legal business name

DE ANZA OBSTETRICS AND GYNECOLOGY MEDICAL GROUP, INC.

Practice address

4190 Chicago Ave
Riverside, CA 92507-5348

Phone

(951) 683-2106

Fax

(951) 683-2105

NPI assigned

Nov 1, 2006

Last updated

Oct 13, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Guillermo ValenzuelaNPI 1730263484

Title

President

Phone

(909) 580-3470

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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.

• Guillermo J Valenzuela, MD

  • Maternal & Fetal Medicine Physician
  • Colton, CA
  • NPI 1730263484
  NPD (past) Authorized official
• Lajean Avon Forbes, CNM

  • Obstetrics & Gynecology Nurse Practitioner
  • Moreno Valley, CA
  • NPI 1013093103
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413158400000",
    "number": "1477630580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1762",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923240857",
            "telephone_number": "951-683-2106",
            "fax_number": "951-638-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 CHICAGO AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925075348",
            "telephone_number": "951-683-2106",
            "fax_number": "951-683-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DE ANZA OBSTETRICS AND GYNECOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-10-13",
        "status": "A",
        "authorized_official_last_name": "VALENZUELA",
        "authorized_official_first_name": "GUILLERMO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-580-3470",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A38671",
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Ivette Villalta De Alba, LCSW
• Jazmin De Anda- Fuentes
• Carol De Anda
• Lesly Monic De Anda
• Nicole De Angelis
• De Anza Surgery Center
• Austin Taylor De Falkenberg
• Kaylee Elizabeth De Falkenberg, B.S.
• Allison Marie De Franco, RN
• Adriana De Groot

• Obstetrics & Gynecology Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; 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.