Active NPI
Rosa M. Reynaga, M.D.
- Internal Medicine Physician
- Norwalk, CA
National Provider Identifier
1689611311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- G53875
- Practice address
- 12729 Pioneer Blvd
Norwalk, CA 90650-2873 - Phone
- (562) 207-2270
- Fax
- (562) 207-2279
- NPI assigned
- Jun 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G53875 | CA | Primary |
Addresses
Primary practice location
12729 Pioneer Blvd
Norwalk, CA 90650-2873
Mailing address
12729 Pioneer Blvd
Norwalk, CA 90650-2873
Phone (562) 207-2270
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014067 | Other | HEALTH NET ID # | |
| 00G538750 | Medicaid | CA | |
| 00G538750 | Other | BLUE SHIELD ID # | |
| 110195911 | Other | RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53875 | CA | MD | Pharmacist |
| G53875 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rubin and McNamara MDS Inc | Past | Accepting new patients | |
| Caremore Medical Group | Internal Medicine | Past | Accepting new patients |
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 and National Provider Directory roles.
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Internal Medicine
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426809600000",
"number": "1689611311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12729 PIONEER BLVD",
"city": "NORWALK",
"state": "CA",
"postal_code": "906502873",
"telephone_number": "562-207-2270",
"fax_number": "562-207-2279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12729 PIONEER BLVD",
"city": "NORWALK",
"state": "CA",
"postal_code": "906502873",
"telephone_number": "562-207-2270",
"fax_number": "562-207-2279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNAGA",
"first_name": "ROSA",
"middle_name": "M.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-01",
"last_updated": "2015-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G53875",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET ID #",
"identifier": "014067",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G538750",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD ID #",
"identifier": "00G538750",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "110195911",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Norwalk, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.