Active NPI
Julian Robert Fuentes, M.D.
- Family Medicine Physician
- Redding, CA
National Provider Identifier
1942269972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G45631
- Practice address
- 3330 Churn Creek Rd Ste D4
Redding, CA 96002-2532 - Phone
- (530) 247-4211
- Fax
- (530) 247-4241
- NPI assigned
- Mar 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G45631 | CA | Primary |
Addresses
Primary practice location
3330 Churn Creek Rd Ste D4
Redding, CA 96002-2532
Mailing address
PO Box 991868
Redding, CA 96099-1868
Phone (530) 339-0025
Other names 1
- Mr. Julian Roberto Fuentes III
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G45631 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John R. Munro M.D. | Family Medicine | Past | Accepting new patients |
| Gateway Medical Center Inc | Past | Accepting new patients | |
| Caremore Medical Group | Family Medicine | Past | Accepting new patients |
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522195200000",
"number": "1942269972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 991868",
"city": "REDDING",
"state": "CA",
"postal_code": "960991868",
"telephone_number": "530-339-0025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3330 CHURN CREEK RD STE D4",
"city": "REDDING",
"state": "CA",
"postal_code": "960022532",
"telephone_number": "530-247-4211",
"fax_number": "530-247-4241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUENTES",
"first_name": "JULIAN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-20",
"last_updated": "2018-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G45631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JULIAN",
"last_name": "FUENTES",
"middle_name": "ROBERTO",
"prefix": "MR.",
"suffix": "III",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.