Individual provider Active NPI

Yvonne Gollin, M.D.

  • Obstetrics & Gynecology Physician
  • Loma Linda, CA
National Provider Identifier
1790899300
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G85078 Issued in CA
Practice address
11370 Anderson St
Ste 3900
Loma Linda, CA 92354-3450
Phone
(909) 558-2806
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G85078 CA Primary

Addresses

Primary practice location

11370 Anderson St
Ste 3900
Loma Linda, CA 92354-3450

Mailing address

54701 File Number
Los Angeles, CA 90074-4701
Phone (909) 558-3111

Other identifiers 1

IdentifierTypeStateIssuer
00G850780MedicaidCA

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
I20070409000353 CA Practitioner - Obstetrics/Gynecology 0042314676 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of California, San Francisco School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Obstetrics of San DiegoGroup PAC ID 6608911482, 4 clinicians

Practice addresses (Care Compare)

12264 El Camino Real
Suite 204
San Diego, CA 92130-3061
Phone (858) 794-7700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G85078CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Mar 21, 2016 Accepting new patients
Specialty Obstetrics of San Diego CurrentSince Jun 24, 2015 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients

Locations

12264 El Camino Real
Ste 204
San Diego, CA 92130
Phone (858) 791-7700

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

12264 El Camino Real
San Diego, CA 92130
Phone (858) 794-7700

3750 Convoy St
Ste 200
San Diego, CA 92111
Phone (858) 794-7700

Organizations & group practices 4

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790899300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54701 FILE NUMBER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701",
            "telephone_number": "909-558-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST",
            "address_2": "STE 3900",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLIN",
        "first_name": "YVONNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G85078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G850780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.