Organization Active NPI

Ganesh Medical Corporation

  • Clinic/Center
  • Apple Valley, CA
National Provider Identifier
1972829729
Registry record updated Apr 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
A504540 Issued in DC
Legal business name
GANESH MEDICAL CORPORATION
Practice address
15982 Tuscola Rd
Apple Valley, CA 92307
Phone
(760) 946-4600
Fax
(760) 946-1696
NPI assigned
Apr 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2010

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

Authorized official

Name
Naresh J Ganesh, MDNPI 1558468942
Title
President
Phone
(760) 946-4600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X A504540 DC Primary

Addresses

Primary practice location

15982 Tuscola Rd
Apple Valley, CA 92307

Mailing address

15982 Tuscola Rd
Apple Valley, CA 92307-2111
Phone (760) 946-4600

Other identifiers 1

IdentifierTypeStateIssuer
00A504540MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050609000451 CA Part B Supplier - Clinic/Group Practice 9335182427 Receives reassigned benefits from 1 practitioner
Practice locations: Apple Valley, CA

National Provider Directory

National Provider Directory

Locations

15982 Tuscola Rd
Ste A
Apple Valley, CA 92307
Phone (760) 946-4600

15982 Tuscola Rd
Apple Valley, CA 92307
Phone (760) 946-4600

Practitioners & affiliated clinicians

Practitioners 1

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": "1271635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271635200000",
    "number": "1972829729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15982 TUSCOLA RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072111",
            "telephone_number": "760-946-4600",
            "fax_number": "760-946-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15982 TUSCOLA RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "92307",
            "telephone_number": "760-946-4600",
            "fax_number": "760-946-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GANESH MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-19",
        "last_updated": "2010-04-19",
        "status": "A",
        "authorized_official_last_name": "GANESH",
        "authorized_official_first_name": "NARESH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-946-4600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "DC",
            "license": "A504540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A504540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.