Individual provider Active NPI

Gilan Angeles Magdangal, NP

  • Family Nurse Practitioner
  • Chino, CA
National Provider Identifier
1538830765
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95018592 Issued in CA
Practice address
5365 Walnut Ave Ste a
Chino, CA 91710-2622
Phone
(909) 902-0009
NPI assigned
Sep 27, 2021
Last updated
Sep 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95018592 CA Primary

Addresses

Primary practice location

5365 Walnut Ave Ste a
Chino, CA 91710-2622

Mailing address

11721 Vale Vista Dr
Fontana, CA 92337-8357
Phone (909) 997-0219

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Chino

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230306001885 CA Practitioner - Nurse Practitioner 6800269283 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95018592CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
David G Song MD Inc CurrentSince Jun 1, 2026 Accepting new patients
Hoag Clinic CurrentSince Mar 24, 2023 Accepting new patients
Chino Stone & Surgery Center PastSince Jun 1, 2026 Accepting new patients

Locations

12611 9th St
Ste C
Chino, CA 91710

5365 Walnut Ave
Ste A
Chino, CA 91710
Phone (626) 234-9178

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

510 Superior Ave
Newport Beach, CA 92663
Phone (800) 400-4624

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

639 E Foothill Blvd
Ste C
San Dimas, CA 91773

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1538830765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11721 VALE VISTA DR",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923378357",
            "telephone_number": "909-997-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5365 WALNUT AVE STE A",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102622",
            "telephone_number": "909-902-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGDANGAL",
        "first_name": "GILAN",
        "middle_name": "ANGELES",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95018592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Chino",
            "affiliation": "N",
            "address_1": "5365 Walnut Ave Ste A",
            "city": "Chino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917102622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

Verify at the official NPI Registry.