Warren Regh C. Gabrillo III M.D. Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A51794 Issued in CA

Legal business name

WARREN REGH C. GABRILLO III M.D. INC.

Practice address

631 N 13TH Ave
A
Upland, CA 91786-4946

Phone

(909) 982-2088

Fax

(909) 982-2058

NPI assigned

Apr 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Warren Regh Camotes Gabrillo III, M.D.NPI 1982689295

Title

President

Phone

(909) 982-2088

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Warren Regh C. Gabrillo III, M.D.

  • Family Medicine Physician
  • Upland, CA
  • NPI 1982689295
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1962622803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 N 13TH AVE",
            "address_2": "A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864946",
            "telephone_number": "909-982-2088",
            "fax_number": "909-982-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 N 13TH AVE",
            "address_2": "A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864946",
            "telephone_number": "909-982-2088",
            "fax_number": "909-982-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN REGH C. GABRILLO III M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "GABRILLO",
        "authorized_official_first_name": "WARREN REGH",
        "authorized_official_middle_name": "CAMOTES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-982-2088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A51794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A517941",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juanfang Wang
• Nan Wang, M.D.
• Nancy Wang, O.D.
• Jeff Warhol
• Uriah Warner
• Cidnie Lynn Warren, BCBA
• Warrior for Children, LLC
• Deborah L Washke, MD
• Sindi Diane Wasserman, MFT
• E. Mark Waterman, AH, DC, IDE

• Family Medicine Physician in Upland, CA
• Providers in Upland, 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 Feb 3, 2010; 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.