Jose D Berganza, M.D Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A055611 Issued in CA

Legal business name

JOSE D BERGANZA, M.D INC

Practice address

14514 Ramona Blvd
Suite 3
Baldwin Park, CA 91706-3305

Phone

(626) 337-0424

Fax

(626) 813-9095

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jose Dalio Berganza, M.DNPI 1003997032

Title

President

Phone

(626) 337-0424

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• SAN JOSE MUILTISPECIALTY MEDICAL GROUP,INC Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 4

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

• Jose Dalio Berganza, M.D.

  • Pediatrics Physician
  • Baldwin Park, CA
  • NPI 1003997032
  Medicare reassignment Authorized official
• Haydee G Castaneda, M.D.

  • General Practice Physician
  • Huntington Park, CA
  • NPI 1689741241
  Medicare reassignment
• Marina H Fernandez, M.D.

  • General Practice Physician
  • Monterey Park, CA
  • NPI 1255354171
  Medicare reassignment
• Patrick Lincoln Maloney, M.D., F.A.C.O.G.

  • Specialist
  • West Covina, CA
  • NPI 1861420069
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1962560896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14514 RAMONA BLVD",
            "address_2": "SUITE 3",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063305",
            "telephone_number": "626-337-0424",
            "fax_number": "626-813-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14514 RAMONA BLVD",
            "address_2": "SUITE 3",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063305",
            "telephone_number": "626-337-0424",
            "fax_number": "626-813-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSE D BERGANZA, M.D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "BERGANZA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "DALIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-337-0424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A055611",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A37324",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "524415",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "557547",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A45608",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "PA12379",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0080790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAN JOSE MUILTISPECIALTY MEDICAL GROUP,INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bervic B. Johns, MD
• Charlie J Johnson Jr., PA
• Daisy Ali Jones
• Anne Y Jong, LCSW
• Maria C. Jong, MD
• Jose Luis Lopez DDS, Inc.
• Jose Manuel Sanchez a Professional Dental Corporation
• JPL LLC
• Jose Luis Juarez
• Robert Juarez Jr., PHYSICAL THERAPIST

• Family Medicine Physician in Baldwin Park, CA
• Providers in Baldwin Park, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.