Christine C Ponzio, M.D.
Individual provider Active NPI Family Medicine Physician · Gonzales, CA
NPI 1790782191 · NPPES record last updated Jan 4, 2016
Key facts
- NPI
- 1790782191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- G48377 (CA)
- Practice address
- 850 5TH St
Gonzales, CA 93926-9491 - Phone
- (831) 675-3601
- Fax
- (831) 675-3966
- NPI assigned
- Jun 30, 2005
- Reactivated
- Apr 10, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120405000330 | CA | Practitioner - Family Practice | 4183603327 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G483377 | CA | MD | Legal Medicine |
| G48377 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Svmhs Clinics | Current |
Accepting new patients | |
| Salinas Valley Memorial Healthcare System | Family Medicine | Current |
Accepting new patients |
| Salinas Valley Memorial Healthcare System | Current |
Accepting new patients | |
| Svmhs Clinics | Current |
Accepting new patients | |
| Astrana Care Hospitalists, a Medical Corporation | Current |
Accepting new patients | |
| Lancelot O Alexander MD a Medical Corporation | Past | Accepting new patients |
Locations
1680 S Garfield Ave
Ste 204
Alhambra, CA 91801
Phone (818) 839-5100
850 5th St
Gonzales, CA 93926
Phone (831) 657-3601
100 Wilson Rd
Ste 100
Monterey, CA 93940
Phone (831) 242-8301
525 N Garfield Ave
Monterey Park, CA 91754
Phone (626) 573-2222
Dept LA 24403
Pasadena, CA 91185
1033 Los Palos Dr
Salinas, CA 93901
Phone (831) 424-2866
450 E Romie Ln
Salinas, CA 93901
Phone (831) 372-7844
869 N Cherry St
Tulare, CA 93274
Phone (559) 326-2800
Interoperability endpoints
- christine-ponzio@gonzalesmedicalgroup.e-mdsdirect.com
- admin@gonzalesmedicalgroup.e-mdsdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | G483377 | CA | |
| Family Medicine Physician | 207Q00000X | G48377 | CA | Yes |
Addresses
Primary practice location
850 5TH St
Gonzales, CA 93926-9491
Mailing address
850 5TH St
Gonzales, CA 93926-9491
Phone (831) 675-3601
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RHM53884G | Medicaid | CA |
Other providers in Gonzales, CA
- Dolores Pena
- Cristina D Perez
- David Leon Perez
- Roger D Pittman
- Alison Poandl
- David M. Ramirez
- Francis Rangel Ventura
- Jesika Rodriguez
- Mireya Samara Ruiz Galvan
- Salinas Valley Memorial Healthcare System
All providers in Gonzales, 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 Jan 4, 2016. 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.