Individual provider Active NPI

Gerardo M General, MD

  • Internal Medicine Physician
  • Chino, CA
National Provider Identifier
1649295635
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A51732 Issued in CA
Practice address
5385 Walnut Ave Ste 5
Chino, CA 91710-2605
Phone
(909) 465-6464
Fax
(909) 465-9544
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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 A51732 CA Primary

Addresses

Primary practice location

5385 Walnut Ave Ste 5
Chino, CA 91710-2605

Mailing address

PO Box 2735
Chino, CA 91708-2735
Phone (909) 465-6464

Other identifiers 1

IdentifierTypeStateIssuer
00A517320MedicaidCA

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
I20100915000279 CA Practitioner - Internal Medicine 5890810832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5385 Walnut Ave
Suite 5
Chino, CA 91710-2605
Phone (909) 465-6464

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A51732CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gerardo M General MD Inc Internal Medicine CurrentSince May 27, 2010 Accepting new patients
Primecare Medical Group Internal Medicine Past Accepting new patients
Prime Healthcare Services - Montclair, LLC Past Accepting new patients

Locations

5385 Walnut Ave
Ste 5
Chino, CA 91710
Phone (909) 374-1492

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282608000000",
    "number": "1649295635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2735",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917082735",
            "telephone_number": "909-465-6464",
            "fax_number": "909-465-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5385 WALNUT AVE STE 5",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102605",
            "telephone_number": "909-465-6464",
            "fax_number": "909-465-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENERAL",
        "first_name": "GERARDO",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2010-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A51732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A517320",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

Verify at the official NPI Registry.