Gisella Victoria Olivares, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A8664 Issued in CA

Practice address

1770 N Orange Grove Ave
Pomona, CA 91767-3027

Phone

(909) 469-9494

Fax

(909) 620-7285

NPI assigned

Feb 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Benacare Medical Center, Inc

  • Family Medicine Physician
  • Upland, CA
  • NPI 1427101369
  Medicare reassignment NPD
• Gracelight Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1104075282
  Medicare reassignment NPD
• Gracelight Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1639241888
  NPD

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1821138405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 N ORANGE GROVE AVE STE 101",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673027",
            "telephone_number": "909-469-9494",
            "fax_number": "909-469-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 N ORANGE GROVE AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673027",
            "telephone_number": "909-469-9494",
            "fax_number": "909-620-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVARES",
        "first_name": "GISELLA",
        "middle_name": "VICTORIA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821138405",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ebele Ojinmah
• Nissi Okolosi
• Alexander Michael Olden
• Sumaiya Olia, DO
• Etneciv Oliva
• Kristy Olive
• Bianca Oliver, PHARM.D
• Eric Brett Oliver, PA-C
• Angela Guadalupe Oliveros
• Christian Olsen

• Family Medicine Physician in Pomona, CA
• Providers in Pomona, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.