Individual provider Active NPI

Geronimo Giraldo Rodriguez, MD

  • Obstetrics & Gynecology Physician
  • Pasadena, CA
National Provider Identifier
1508936675
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A36572 Issued in CA
Practice address
31 W Bellevue Dr
Pasadena, CA 91105-2501
Phone
(626) 577-8138
Fax
(626) 577-7458
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A36572 CA Primary

Addresses

Primary practice location

31 W Bellevue Dr
Pasadena, CA 91105-2501

Mailing address

31 W Bellevue Dr
Pasadena, CA 91105-2501
Phone (626) 577-8138

Other identifiers 1

IdentifierTypeStateIssuer
00A365720MedicaidCA

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
I20101209000211 CA Practitioner - Obstetrics/Gynecology 5496942930 Practice locations: Los Angeles, CA; Pasadena, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A36572CAMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1508936675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W BELLEVUE DR",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052501",
            "telephone_number": "626-577-8138",
            "fax_number": "626-577-7458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W BELLEVUE DR",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052501",
            "telephone_number": "626-577-8138",
            "fax_number": "626-577-7458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "GERONIMO",
        "middle_name": "GIRALDO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A36572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A365720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.