Individual provider Active NPI

Gloria Rae Engel, MD

  • Internal Medicine Physician
  • Yucaipa, CA
National Provider Identifier
1780675009
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G75509 Issued in CA
Practice address
38575 Wildflower LN
Yucaipa, CA 92399-7012
Phone
(760) 641-1930
Fax
(909) 247-3313
NPI assigned
Nov 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G75509 CA Primary

Addresses

Primary practice location

38575 Wildflower LN
Yucaipa, CA 92399-7012

Mailing address

38575 Wildflower LN
Yucaipa, CA 92399-7012
Phone (760) 641-1930

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
I20041020000462 CA Practitioner - Internal Medicine 1850205956 Practice locations: Yucaipa, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G75509CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1780675009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38575 WILDFLOWER LN",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923997012",
            "telephone_number": "760-641-1930",
            "fax_number": "760-247-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38575 WILDFLOWER LN",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923997012",
            "telephone_number": "760-641-1930",
            "fax_number": "909-247-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGEL",
        "first_name": "GLORIA",
        "middle_name": "RAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G75509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucaipa, CA

Sources for this page

Verify at the official NPI Registry.