Individual provider Active NPI

David Regan Gonzalez, MD

  • Family Medicine Physician
  • Mission Viejo, CA
National Provider Identifier
1508860016
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G078684 Issued in CA
Practice address
26732 Crown Valley Pkwy Ste 151
Mission Viejo, CA 92691-6337
Phone
(949) 347-6044
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G078684 CA Primary

Addresses

Primary practice location

26732 Crown Valley Pkwy Ste 151
Mission Viejo, CA 92691-6337

Mailing address

26732 Crown Valley Pkwy Ste 151
Mission Viejo, CA 92691-6337
Phone (949) 347-6044

Other practice location 1

26732 Crown Valley Pkwy
Ste 461
Mission Viejo, CA 92691-6306
Phone (949) 347-2566

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dgonzalez1373893@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181015000549 CA Practitioner - Family Practice 8426377607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Irvine, California College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

24321 Avenida de la Carlota
Laguna Hills, CA 92653-3681
Phone (949) 204-3006

26732 Crown Valley Pkwy
Mission Viejo, CA 92691-6337

Hospital & facility affiliations

  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G078684CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Family Medicine CurrentSince Aug 27, 2018 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation Family Medicine CurrentSince Aug 27, 2018 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

26522 La Alameda
Ste 120
Mission Viejo, CA 92691
Phone (949) 282-1671

26732 Crown Valley Pkwy
Ste 151
Mission Viejo, CA 92691
Phone (949) 347-6044

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

26732 Crown Valley Pkwy
Ste 170
Mission Viejo, CA 92691
Phone (949) 364-7246

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1508860016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26732 CROWN VALLEY PKWY STE 151",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916337",
            "telephone_number": "949-347-6044",
            "fax_number": "949-347-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26732 CROWN VALLEY PKWY STE 151",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916337",
            "telephone_number": "949-347-6044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26732 Crown Valley Pkwy",
            "address_2": "Ste 461",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926916306",
            "country_code": "US",
            "telephone_number": "949-347-2566",
            "fax_number": "949-347-1606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "DAVID",
        "middle_name": "REGAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G078684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgonzalez1373893@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "26732 Crown Valley Pkwy",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926916306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.