Gary Vandenberg, MD

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

C33053 Issued in CA

Practice address

9834 Genesee Ave
Suite 326
La Jolla, CA 92037-1223

Phone

(858) 453-3813

Fax

(858) 453-1727

NPI assigned

Apr 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: gvandenberg71261@scrippshlth.medalliesdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gary Vandenberg,Jr., M.D.,Inc.

  • Primary Care Clinic/Center
  • La Jolla, CA
  • NPI 1306355714
  Authorized official Same address or phone
• Scripps Health

  dba Scripps Hospital Medical Services

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912122680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9834 GENESEE AVE",
            "address_2": "SUITE 326",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371223",
            "telephone_number": "858-453-3813",
            "fax_number": "858-453-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9834 GENESEE AVE",
            "address_2": "SUITE 326",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371223",
            "telephone_number": "858-453-3813",
            "fax_number": "858-453-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBERG",
        "first_name": "GARY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "C33053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika J. Van Hulzen, P.A.-C.
• Kris J. Van Lom, M.D.
• Christoffel Johannes Van Niekerk, M.D.
• Michelle Ubels Van Noord, M.D.
• Mia Van Peenen, FNP BC
• Sarah Jeanne Vanderhoff, MSN, APRN, CNS
• Svea Marie Vanparys, PHARMD
• Frida C Vargas, FNP
• Maria Camila Vargas, MD
• Rex Vargas

• Legal Medicine in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Legal Medicine in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.