Individual provider Active NPI

Gerardo Daniel Lopez, FNP-C

  • Family Nurse Practitioner
  • Coachella, CA
National Provider Identifier
1760254296
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95027645 Issued in CA
Practice address
1293 6TH St
Coachella, CA 92236-1707
Phone
(760) 391-5151
NPI assigned
Oct 27, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95027645 CA Primary

Addresses

Primary practice location

1293 6TH St
Coachella, CA 92236-1707

Mailing address

79753 Randolph CT
La Quinta, CA 92253-4070
Phone (623) 229-9749

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241025001570 CA Practitioner - Nurse Practitioner 3577096833 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95027645CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indio Emergency Med Group Inc CurrentSince Oct 1, 2024 Accepting new patients
Coachella Valley Care Medical Associates Inc CurrentSince Oct 1, 2024 Accepting new patients
Indio Emergency Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

1293 6th St
Coachella, CA 92236
Phone 7603915151 ext. 2

81767 Doctor Carreon Blvd
Ste 201
Indio, CA 92201

81709 Doctor Carreon Blvd
Ste C3
Indio, CA 92201
Phone (760) 342-6404

79440 Corporate Center Dr
Ste 110
La Quinta, CA 92253
Phone (760) 564-3533

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1760254296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79753 RANDOLPH CT",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534070",
            "telephone_number": "623-229-9749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1293 6TH ST",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361707",
            "telephone_number": "760-391-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "GERARDO",
        "middle_name": "DANIEL",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95027645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coachella, CA

Sources for this page

Verify at the official NPI Registry.