Organization Active NPI

Gamal F Ghaly MD Inc a Professional Corporation

  • Internal Medicine Physician
  • Moreno Valley, CA
National Provider Identifier
1659603157
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A44392 Issued in CA
Legal business name
GAMAL F GHALY MD INC A PROFESSIONAL CORPORATION
Practice address
14114 Business Center Dr
Suite G
Moreno Valley, CA 92553-9113
Phone
(951) 656-5333
Fax
(951) 243-2074
NPI assigned
Feb 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Authorized official

Name
Gamal F Ghaly, MDNPI 1083790513
Title
President
Phone
(951) 243-2045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A44392 CA Primary

Addresses

Primary practice location

14114 Business Center Dr
Suite G
Moreno Valley, CA 92553-9113

Mailing address

14114 Business Center Dr
Suite G
Moreno Valley, CA 92553-9113
Phone (951) 656-5333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100727000927 CA Part B Supplier - Clinic/Group Practice 3072646058 Receives reassigned benefits from 1 practitioner
Practice locations: Moreno Valley, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0871194Gamal Ghaly, MD14114 Business Center Drive Suite G, Moreno Valley, CA 92553Certificate of waiverSep 23, 2026

National Provider Directory

National Provider Directory

Locations

14114 Business Center Dr
Ste G
Moreno Valley, CA 92553
Phone (951) 243-2045

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1659603157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14114 BUSINESS CENTER DR",
            "address_2": "SUITE G",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925539113",
            "telephone_number": "951-656-5333",
            "fax_number": "951-243-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14114 BUSINESS CENTER DR",
            "address_2": "SUITE G",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925539113",
            "telephone_number": "951-656-5333",
            "fax_number": "951-243-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAMAL F GHALY MD INC A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-08",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "GHALY",
        "authorized_official_first_name": "GAMAL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-243-2045",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A44392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.