Organization Active NPI

Digestive and Liver Diseases Specialists, a Medical Group Inc.

  • Gastroenterology Physician
  • Whittier, CA
National Provider Identifier
1912185463
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A52987 Issued in CA
Legal business name
DIGESTIVE AND LIVER DISEASES SPECIALISTS, A MEDICAL GROUP INC.
Practice address
14350 E.Whittier Blvd.
Suite 205
Whittier, CA 90605-2138
Phone
(562) 693-9870
Fax
(562) 404-3710
NPI assigned
Feb 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Authorized official

Name
Dr. Rangarao Panguluri, M.D.
Title
Secretary
Phone
(562) 693-9870

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X A52987 CA
Gastroenterology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RG0100X A52987 CA Primary

Addresses

Primary practice location

14350 E.Whittier Blvd.
Suite 205
Whittier, CA 90605-2138

Mailing address

13000 Mozart Way
Cerritos, CA 90703-1379
Phone (562) 404-7848

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040105000891 CA Part B Supplier - Clinic/Group Practice 8729987144 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baldwin Park, CA; Whittier, CA; Garden Grove, CA; Anaheim, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1771 W Romneya Dr
Ste C
Anaheim, CA 92801
Phone (714) 520-3000

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": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1912185463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 MOZART WAY",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031379",
            "telephone_number": "562-404-7848",
            "fax_number": "562-404-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14350 E.WHITTIER BLVD.",
            "address_2": "SUITE 205",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906052138",
            "telephone_number": "562-693-9870",
            "fax_number": "562-404-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE AND LIVER DISEASES SPECIALISTS, A MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "PANGULURI",
        "authorized_official_first_name": "RANGARAO",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "562-693-9870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A52987",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A52987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.