Active NPI
Robert Will Reboya Gonzalez, IDC
- Military Health Care Provider
- San Diego, CA
National Provider Identifier
1801489299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- Practice address
- 34101 Farenholt Ave BLDG 14
San Diego, CA 92134-7000 - Phone
- (619) 532-7968
- NPI assigned
- Feb 16, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | Primary |
Addresses
Primary practice location
34101 Farenholt Ave BLDG 14
San Diego, CA 92134-7000
Mailing address
36421 Flower Basket Rd
Winchester, CA 92596-8675
Phone (562) 304-0891
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United States Navy | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Military Hospital
- San Diego, CA
- NPI 1003226309
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613433600000",
"number": "1801489299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36421 FLOWER BASKET RD",
"city": "WINCHESTER",
"state": "CA",
"postal_code": "925968675",
"telephone_number": "562-304-0891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34101 FARENHOLT AVE BLDG 14",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921347000",
"telephone_number": "619-532-7968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REBOYA GONZALEZ",
"first_name": "ROBERT",
"middle_name": "WILL",
"credential": "IDC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-16",
"last_updated": "2021-02-16",
"certification_date": "2021-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.