NPIMap

Organization Active NPI

Gateway Comprehensive Medical Group

  • General Practice Physician
  • San Diego, CA
National Provider Identifier
1831490184
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A54452 Issued in CA
Legal business name
GATEWAY COMPREHENSIVE MEDICAL GROUP
Practice address
995 Gateway Center Way
Suite 105
San Diego, CA 92102-4500
Phone
(619) 264-1934
NPI assigned
Nov 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Authorized official

Name
Tarek Hassanein, M.D.NPI 1801854450
Title
Director
Phone
(619) 990-1698

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X A54452 CA Primary

Addresses

Primary practice location

995 Gateway Center Way
Suite 105
San Diego, CA 92102-4500

Mailing address

PO Box 181770
Coronado, CA 92178-1770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121228000360 CA Part B Supplier - Clinic/Group Practice 3577716471 Receives reassigned benefits from 1 practitioner
Practice locations: Chula Vista, CA; San Diego, CA

National Provider Directory

National Provider Directory
Tax ID family
Gateway Comprehensive Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2436 Fenton St
Ste 100B
Chula Vista, CA 91914
Phone (619) 264-1934

256 Landis Ave
Ste 202
Chula Vista, CA 91910
Phone (619) 522-0399

1503 N Imperial Ave
Ste 201
El Centro, CA 92243
Phone (760) 337-1000

735 E Ohio Ave
Ste 201
Escondido, CA 92025
Phone (619) 303-8341

488 E Valley Pkwy
Ste 313
Escondido, CA 92025
Phone (619) 741-6976

995 Gateway Center Way
San Diego, CA 92102
Phone (619) 232-6454

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1831490184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 181770",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921781770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 GATEWAY CENTER WAY",
            "address_2": "SUITE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024500",
            "telephone_number": "619-264-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY COMPREHENSIVE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-03",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "HASSANEIN",
        "authorized_official_first_name": "TAREK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "619-990-1698",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A54452",
            "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 Apr 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.