Organization Active NPI

Fernando Ibarra M D Inc

  • Gastroenterology Physician
  • Monterey Park, CA
National Provider Identifier
1912180969
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
FERNANDO IBARRA M D INC
Practice address
850 S Atlantic Blvd
Ste # 101
Monterey Park, CA 91754-4730
Phone
(626) 284-1350
Fax
(626) 284-2454
NPI assigned
Dec 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Authorized official

Name
Dr. Fernando Ibarra, MDNPI 1013082726
Title
Owner
Phone
(626) 284-1350

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
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

850 S Atlantic Blvd
Ste # 101
Monterey Park, CA 91754-4730

Mailing address

850 S Atlantic Blvd
Ste # 101
Monterey Park, CA 91754-4730
Phone (626) 284-1350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080118000655 CA Part B Supplier - Clinic/Group Practice 3779664453 Receives reassigned benefits from 3 practitioners
Practice locations: Monterey Park, CA; South El Monte, CA; Montebello, CA; Los Angeles, CA; Huntington Park, CA

National Provider Directory

National Provider Directory

Locations

1401 E Cesar E Chavez Ave
Los Angeles, CA 90033

850 S Atlantic Blvd
Ste 101
Monterey Park, CA 91754
Phone (626) 281-6200

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556668800000",
    "number": "1912180969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S ATLANTIC BLVD",
            "address_2": "STE # 101",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544730",
            "telephone_number": "626-284-1350",
            "fax_number": "626-284-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S ATLANTIC BLVD",
            "address_2": "STE # 101",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544730",
            "telephone_number": "626-284-1350",
            "fax_number": "626-284-2454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERNANDO IBARRA M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2019-05-01",
        "status": "A",
        "authorized_official_last_name": "IBARRA",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-284-1350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.