Gerardo Baltierra

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

Practice address

13177 Ramona Blvd
Baldwin Park, CA 91706-3855

Phone

(626) 337-3828

NPI assigned

Nov 26, 2018

Last updated

Nov 26, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1710457429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4319 HARLAN AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917062857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13177 RAMONA BLVD",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063855",
            "telephone_number": "626-337-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTIERRA",
        "first_name": "GERARDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "D8491732",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98534377E47284",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baldwin Park Medical Center
• Baldwin Park Medical Center Inc
• Baldwin Park Medical Center, Inc.
• Baldwin Park Medical Clinic Inc
• Baldwin Park Unified School District
• Balwin Park Medical Group, Inc.
• Mira Bansil, PA
• Ariana Malagon Banuelos, MD
• Cassandra Nichole Banuelos, RN
• Karina Lisset Barahoona Jr.

• Military Health Care Provider in Baldwin Park, CA
• Providers in Baldwin Park, CA by specialty
• Military Health Care Provider in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.