Individual provider Active NPI

Eunice Alvarez Gomez

  • Nurse Practitioner
  • Temecula, CA
National Provider Identifier
1841608015
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
710743 Issued in CA
Practice address
40300 Atmore CT
Temecula, CA 92591-1621
Phone
(310) 756-8098
NPI assigned
Jul 31, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 710743 CA Primary

Addresses

Primary practice location

40300 Atmore CT
Temecula, CA 92591-1621

Mailing address

40300 Atmore CT
Temecula, CA 92591-1621
Phone (310) 756-8098

Other identifiers 1

IdentifierTypeStateIssuer
710743OtherCACALIFORNIA NURSING LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170623002377 CA Practitioner - Nurse Practitioner 2163790692 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95000384CAMDRegistered Nurse
710743CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minghsun Liu, M.D., PC CurrentSince Mar 1, 2020 Accepting new patients

Locations

11103 Venice Blvd
Los Angeles, CA 90034
Phone (310) 734-8526

200 S Park Rd
Ste 200
Hollywood, FL 33021
Phone (866) 986-2263

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.

NPI Registry JSON

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1841608015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40300 ATMORE CT",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925911621",
            "telephone_number": "310-756-8098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40300 ATMORE CT",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925911621",
            "telephone_number": "310-756-8098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "EUNICE",
        "middle_name": "ALVAREZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "710743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA NURSING LICENSE",
            "identifier": "710743",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.