Organization Active NPI

PJ Benipal MD Inc

  • Gastroenterology Physician
  • Santa Maria, CA
National Provider Identifier
1730214602
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A64620 Issued in CA
Legal business name
PJ BENIPAL MD INC
Practice address
116 S Palisade Dr Ste 210
Santa Maria, CA 93454-8906
Phone
(805) 347-7355
Fax
(805) 347-7354
NPI assigned
Feb 22, 2007
Last updated
Jan 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Authorized official

Name
Mrs. Gloria Moreno
Title
Office Manager
Phone
(805) 347-2722

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A64620 CA Primary

Addresses

Primary practice location

116 S Palisade Dr Ste 210
Santa Maria, CA 93454-8906

Mailing address

116 S Palisade Dr Ste 210
Santa Maria, CA 93454-8906
Phone (805) 347-7355

Other identifiers 2

IdentifierTypeStateIssuer
A64620OtherCALICENSE NUMBER
00A646200MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1730214602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S PALISADE DR STE 210",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934548906",
            "telephone_number": "805-347-7355",
            "fax_number": "805-347-7354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S PALISADE DR STE 210",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934548906",
            "telephone_number": "805-347-7355",
            "fax_number": "805-347-7354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PJ BENIPAL MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "MORENO",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "805-347-2722",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A64620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "A64620",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A646200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.