Cal Med Endoscopy Center LLC

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

Legal business name

CAL MED ENDOSCOPY CENTER LLC

Practice address

1281 W C St
Colton, CA 92324-1916

Phone

(909) 580-3353

NPI assigned

Jul 23, 2018

Last updated

Apr 25, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dev Gnanadev, MDNPI 1104933985

Title

Owner

Phone

(909) 580-3353

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982181939. Details of each certification follow.

• CCN 55C0001179 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 55C0001179

Legal name

Cal Med Endoscopy Center, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Sep 12, 2023

Last certification

Nov 8, 2023

Facility address

1281 W. C Street, Suite 150
Colton, CA 92324

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dev Appannagari Gnanadev, MD

  • Surgery Physician
  • Colton, CA
  • NPI 1104933985
  NPD (past) Authorized official
• Samuel Schwartz, MD

  • Vascular Surgery Physician
  • Colton, CA
  • NPI 1255563334
  NPD (past)

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1982181939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1281 W C ST",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241916",
            "telephone_number": "909-679-2754",
            "fax_number": "909-423-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1281 W C ST",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241916",
            "telephone_number": "909-580-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAL MED ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-23",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "GNANADEV",
        "authorized_official_first_name": "DEV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-580-3353",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grethel Alba Cabison, MD
• Eduardo Cabrera
• Nicole Cabrera
• David Cadena
• Cal Med ASC LLC
• Cal Med Physicians and Surgeons, Inc.
• Cal Med Vascular ASC LLC
• Cal Med Vascular Center LLC
• Renae Soledad Caldera
• Dean Caldwell

• Endoscopy Clinic/Center in Colton, CA
• Providers in Colton, CA by specialty
• Endoscopy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.