Greggory R. Devore M.D. a Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

G44446 Issued in CA

Legal business name

GREGGORY R. DEVORE M.D. A MEDICAL CORPORATION

Practice address

50 Alessandro PL Ste 330
Pasadena, CA 91105-3187

Phone

(626) 583-8911

Fax

(626) 583-8894

NPI assigned

Oct 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Greggory Russell Devore, M.D.NPI 1851305312

Title

President

Phone

(626) 583-8911

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Fetal Diagnostic Center of Pasadena, Inc. Doing business as

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

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

• Greggory Russell Devore, M.D.

  • Maternal & Fetal Medicine Physician
  • Pasadena, CA
  • NPI 1851305312
  NPD (past) Authorized official

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1679762702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ALESSANDRO PL STE 330",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053187",
            "telephone_number": "626-583-8911",
            "fax_number": "626-583-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ALESSANDRO PL STE 330",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053187",
            "telephone_number": "626-583-8911",
            "fax_number": "626-583-8894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 S Fair Oaks Ave",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911052662",
            "country_code": "US",
            "telephone_number": "626-583-8911",
            "fax_number": "626-583-8894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GREGGORY R. DEVORE M.D. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "DEVORE",
        "authorized_official_first_name": "GREGGORY",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-583-8911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G44446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G444460",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G444461",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679762702",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fetal Diagnostic Center of Pasadena, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fetal Diagnostic Center of Pasadena, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• McKenna Anne Greenleaf Faulk, BS
• Wendy Lee Greenleaf, MFT TRAINEE
• Donna Greenman
• Katherine Deetta Greenwalt, FNP-C
• Victoria Greenwood
• Evelyn Gregorian, RN
• Gregory E Gray MD
• Gregory Ohanian DDS Ms Inc.
• Kolleen Elizabeth Gregory, DC
• Lili Elizabeth Gregory

• Specialist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.