Individual provider Active NPI

Gabriel Noah Waterman, MD, MBA

  • Internal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1639556434
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A144802 Issued in CA
Practice address
3800 Kilroy Airport Way Ste 100
Long Beach, CA 90806-6818
Phone
(888) 828-7226
Fax
(424) 222-7755
NPI assigned
Apr 30, 2015
Last updated
Oct 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A144802 CA Primary

Addresses

Primary practice location

3800 Kilroy Airport Way Ste 100
Long Beach, CA 90806-6818

Mailing address

3800 Kilroy Airport Way Ste 100
Long Beach, CA 90806-6818
Phone (888) 828-7226

Other identifiers 1

IdentifierTypeStateIssuer
GW3232267556MedicaidCA

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
I20200124001193 CA Practitioner - Internal Medicine 5294014734 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A144802CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albion Medical Partners of California West P C Internal Medicine CurrentSince Feb 1, 2021 Accepting new patients
Scan Desert Health Plan, Inc Current Accepting new patients

Locations

12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

3800 Kilroy Airport Way
Ste 100
Long Beach, CA 90806
Phone (559) 249-1867

Interoperability endpoints

  • Direct secure messaging: gabriel.waterman.1@30710.direct.athenahealth.com

Organizations & group practices 2

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": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1639556434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 KILROY AIRPORT WAY STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908066818",
            "telephone_number": "888-828-7226",
            "fax_number": "424-222-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 KILROY AIRPORT WAY STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908066818",
            "telephone_number": "888-828-7226",
            "fax_number": "424-222-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "GABRIEL",
        "middle_name": "NOAH",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-30",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A144802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GW3232267556",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.