Bertha a Gonzalez DO, Inc

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

20A6849 Issued in CA

Legal business name

BERTHA A GONZALEZ DO, INC

Doing business as

N/a

Practice address

3106 W Beverly Blvd
Montebello, CA 90640-2217

Phone

(323) 728-1274

Fax

(323) 720-9954

NPI assigned

Jan 22, 2008

Last updated

Jan 22, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

N/AAs reported in NPPES

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

Authorized official

Name

Dr. Bertha A Gonzalez, DONPI 1932295680

Title

President

Phone

(323) 728-1274

Specialties & licenses 1

Addresses

Other names 1

• N/A Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Bertha a Gonzalez DO Inc

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25347/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bertha Alicia Gonzalez, D.O.

  • Family Medicine Physician
  • Montebello, CA
  • NPI 1932295680
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1841477767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3106 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402217",
            "telephone_number": "323-728-1274",
            "fax_number": "323-720-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402217",
            "telephone_number": "323-728-1274",
            "fax_number": "323-720-9954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERTHA A GONZALEZ DO, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "N/A",
        "enumeration_date": "2008-01-22",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "BERTHA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-728-1274",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "20A6849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "N/A",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Niku Bensoussan, PA-C
• Patricia Beristain
• Ross Albert Berliner, DPM
• Edwin Anthony Bermudez Barron, PHARM.D.
• Janeece A Berry, RNP
• Delia Betancourt Manale, COTA
• Beverly Ambulatory Med-Surg Center, PC
• Beverly Care Medical Group, Inc
• Beverly Community Hospital Association (Beverly Hospital)
• Beverly Hospital

• Exclusive Provider Organization in Montebello, CA
• Providers in Montebello, CA by specialty
• Exclusive Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.