Individual provider Active NPI

Guillermo Saenz Zavala, MD

  • Family Medicine Physician
  • Fontana, CA
National Provider Identifier
1720475478
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A153513 Issued in CA
Practice address
17234 Valley Blvd
Fontana, CA 92335
Phone
(909) 427-5084
Fax
(909) 427-5022
NPI assigned
Apr 21, 2015
Last updated
Aug 2, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X A153513 CA Primary

Addresses

Primary practice location

17234 Valley Blvd
Fontana, CA 92335

Mailing address

17234 Valley Blvd
Fontana, CA 92335

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
I20190426000962 CA Practitioner - Family Practice 1658613450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temecula Valley Family Physicians Inc.Group PAC ID 6507954401, 5 clinicians

Practice addresses (Care Compare)

31720 Temecula Pkwy
Suite 203
Temecula, CA 92592-5895
Phone (951) 302-4700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A153513CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temecula Valley Family Physicians Inc. Family Medicine CurrentSince May 3, 2021 Accepting new patients
Dap Health, Inc. Family Medicine Current Accepting new patients
Doctors Hospital of Riverside LLC Past Accepting new patients

Locations

3989 W Stetson Ave
Ste 100
Hemet, CA 92545
Phone (951) 765-7002

126 Avocado Ave
Ste 206
Perris, CA 92571

31720 US Highway 79
Ste 203
Temecula, CA 92592
Phone (951) 302-4700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1720475478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17234 VALLEY BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "92335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17234 VALLEY BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "92335",
            "telephone_number": "909-427-5084",
            "fax_number": "909-427-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAENZ ZAVALA",
        "first_name": "GUILLERMO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-21",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A153513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.