Individual provider Active NPI

Gerald Magcumot Coronado, MD

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1942998463
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A197519 Issued in CA
Practice address
5454 El Cajon Blvd
San Diego, CA 92115-3621
Phone
(619) 515-2400
NPI assigned
Apr 25, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X A197519 CA Primary

Addresses

Primary practice location

5454 El Cajon Blvd
San Diego, CA 92115-3621

Mailing address

5454 El Cajon Blvd
San Diego, CA 92115-3621
Phone (619) 515-2400

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250625004001 CA Practitioner - Family Practice 7012429830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Virginia Commonwealth University, School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Centers of San Diego IncGroup PAC ID 3476446378, 299 clinicians

Practice addresses (Care Compare)

3705 Mission Blvd
San Diego, CA 92109-7104
Phone (619) 515-2444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A197519CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Jul 7, 2025 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Jul 7, 2025 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients

Locations

525 E Main St
El Cajon, CA 92020
Phone (619) 334-3787

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

5454 El Cajon Blvd
San Diego, CA 92115
Phone (619) 515-2381

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

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.

NPI Registry JSON

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1942998463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5454 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921153621",
            "telephone_number": "619-515-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5454 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921153621",
            "telephone_number": "619-515-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONADO",
        "first_name": "GERALD",
        "middle_name": "MAGCUMOT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-25",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A197519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.