Gateway Medical Group of San Diego

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

W13278 Issued in CA

Legal business name

GATEWAY MEDICAL GROUP OF SAN DIEGO

Practice address

752 Medical Center CT
Suite 210
Chula Vista, CA 91911-6658

Phone

(619) 527-7700

Fax

(619) 527-3226

NPI assigned

Jun 3, 2006

Last updated

Aug 19, 2009By 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. Ronald D Sanzone, DONPI 1457393381

Title

President

Phone

(619) 527-7700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gateway Medical Group Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 11

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.

• Ronald D Sanzone, DO

  • Family Medicine Physician
  • National City, CA
  • NPI 1457393381
  Medicare reassignment Care Compare group NPD Authorized official
• Joseph R Novencido, D.O.

  • Family Medicine Physician
  • National City, CA
  • NPI 1619239118
  Medicare reassignment Care Compare group NPD
• Sandra De Roldan, NP

  • Family Nurse Practitioner
  • National City, CA
  • NPI 1235479627
  Medicare reassignment NPD
• Merritt S Matthews, MD

  • Family Medicine Physician
  • National City, CA
  • NPI 1720024755
  Medicare reassignment NPD
• Rafael A Garcia, MD

  • Pediatrics Physician
  • National City, CA
  • NPI 1053414086
  NPD
• Britnee Marie Campos, PA

  • Physician Assistant
  • San Diego, CA
  • NPI 1588313175
  NPD (past)
• Danielle Marie Lindgren, PA

  • Physician Assistant
  • Chula Vista, CA
  • NPI 1639956287
  NPD (past)
• Gustavo Antonio Mondragon Jr., M.D.

  • Family Medicine Physician
  • Chula Vista, CA
  • NPI 1770773434
  NPD (past)
• Paavan Patel

  • Family Medicine Physician
  • Hesperia, CA
  • NPI 1376076885
  NPD (past)
• Anita Mohan Whitaker

  • Physician Assistant
  • Escondido, CA
  • NPI 1780146837
  NPD (past)
• Emily Geiger Maxwell, PA-C

  • Physician Assistant
  • Bend, OR
  • NPI 1134647241
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250640000000",
    "number": "1568400455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 EUCLID AVE",
            "address_2": "SUITE 207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143610",
            "telephone_number": "619-527-7700",
            "fax_number": "619-527-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 MEDICAL CENTER CT",
            "address_2": "SUITE 210",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116658",
            "telephone_number": "619-527-7700",
            "fax_number": "619-527-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY MEDICAL GROUP OF SAN DIEGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2009-08-19",
        "status": "A",
        "authorized_official_last_name": "SANZONE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-527-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "W13278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0062450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Medical Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Andrea Gasca
• Anna Karen Gastelum Hernandez
• Erik Gastelum
• Jackeline Gastelum
• Rachelle Beltran Gatchalian
• Deanna Gaudet
• Janelle M Gavagan, RN
• Angelica Rodriguez Gavino, MFT
• Lauren Gaw
• Ilse Gaxiola

• Family Medicine Physician in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.