Gregory A Talavera, M.D.
Individual provider Active NPI Family Medicine Physician · San Ysidro, CA
NPI 1740337161 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1740337161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A40061 (CA)
- Practice address
- 4004 Beyer Blvd
San Ysidro, CA 92173-2007 - Phone
- (619) 428-4463
- Fax
- (619) 428-7952
- NPI assigned
- Jan 5, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041227000740 | CA | Practitioner - Preventive Medicine | 6800854613 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A40061 | CA | MD | Public Health & General Preventive Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centro de Salud de la Comunidad de San Ysidro, Inc. | Current |
Accepting new patients | |
| Centro de Salud de la Comunidad de San Ysidro Inc | Current |
Accepting new patients | |
| Centro de Salud de la Comunidad de San Ysidro, Inc. | Current | Accepting new patients | |
| Centro de Salud de la Comunidad de San Ysidro, Inc. | Past | Accepting new patients | |
| Sharp Chula Vista Medical Center | Past | Accepting new patients | |
| Grossmont Hospital Corporation | Past | Accepting new patients | |
| Regents of the University of California | Past | Accepting new patients | |
| Scripps Health | Past | Accepting new patients | |
| Sharp Memorial Hospital | Past | Accepting new patients |
Locations
865 Third Ave
Ste 133
Chula Vista, CA 91911
Phone (619) 205-1360
678 Third Ave
Chula Vista, CA 91910
Phone (619) 205-6349
1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780
1136 D Ave
National City, CA 91950
Phone (619) 336-2300
1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585
4004 Beyer Blvd
San Ysidro, CA 92173
Phone (619) 428-1330
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A40061 | CA | Yes |
| Public Health & General Preventive Medicine Physician | 2083P0901X | A40061 | CA |
Addresses
Primary practice location
4004 Beyer Blvd
San Ysidro, CA 92173-2007
Mailing address
4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 428-4463
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A40061 | Other | CA | CA. LICENSE |
Other providers in San Ysidro, CA
- Manuela Mercedes Soto-Mendez
- Aurelia Stephens
- Jayson Wayne Paul Stilwell
- Elissa Kim Sullivan
- Ramon Sy
- Lo Fu Tan
- Elizabeth Tec
- Francisco Javier Tejeda
- Celeste Carina Torres
- Jennifer N Torres
All providers in San Ysidro, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.