Individual provider Active NPI

Robert J Mehler, M.D.

  • Gastroenterology Physician
  • San Gabriel, CA
National Provider Identifier
1730259243
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G12425 Issued in CA
Practice address
416 W Las Tunas Dr
Suite # 200
San Gabriel, CA 91776-1236
Phone
(626) 281-7461
Fax
(626) 281-8827
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G12425 CA Primary

Addresses

Primary practice location

416 W Las Tunas Dr
Suite # 200
San Gabriel, CA 91776-1236

Mailing address

416 W Las Tunas Dr
Suite # 200
San Gabriel, CA 91776-1236
Phone (626) 281-7461

Other identifiers 1

IdentifierTypeStateIssuer
00G124250MedicaidCA

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
I20060302000374 CA Practitioner - Gastroenterology 3274549019 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G12425CAMDGastroenterology Physician
12425CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation Gastroenterology CurrentSince Dec 18, 2008 Accepting new patients
Providence Facey Medical Foundation CurrentSince Dec 18, 2008 Accepting new patients

Locations

File 50670
Los Angeles, CA 90074

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

416 W Las Tunas Dr
Ste 200
San Gabriel, CA 91776
Phone (626) 281-7461

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1730259243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 W LAS TUNAS DR",
            "address_2": "SUITE # 200",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761236",
            "telephone_number": "626-281-7461",
            "fax_number": "626-281-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 W LAS TUNAS DR",
            "address_2": "SUITE # 200",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761236",
            "telephone_number": "626-281-7461",
            "fax_number": "626-281-8827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHLER",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G12425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G124250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

Verify at the official NPI Registry.