DR. GARY D BOTIMER (NPI# 1124018114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124018114 |
| Entity Type | Individual |
| Full Name | DR. GARY D BOTIMER |
| Credential | MD |
| Practice Address |
25455 Barton Rd Ste 102b Loma Linda CA 92354-3128 |
| Practice Telephone | 9095582808 |
| Practice Fax Number | 9095585599 |
| Mailing Telephone | 9095582808 |
| Mailing Fax Number | 9095585599 |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2015-02-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | M4699 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE SHIELD | 000010005946 | 01 |
| ID | BLUE SHIELD | 000010005947 | 01 |
| ID | BLUE SHIELD | 33555 | 01 |
| ID | BLUE CROSS | 46995 | 01 |
| ID | BLUE CROSS | B0891 | 01 |
| ID | RAILROAD MEDICARE | 200011749 | 01 |
| ID | BLUE SHIELD | 000010147414 | 01 |
| ID | 002363100 | 05 |
| Street Address |
25455 BARTON RD STE 102B |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92354-3128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033753249 | Victoria V Teppone | Family Medicine | 25455 Barton Rd, Loma Linda, CA 92354-3128 | 2019-10-30 |
| 1376991059 | Russell Irving Carl Erickson Iv | Student in an Organized Health Care Education/Training Program | 25455 Barton Rd, Suite 206a, Loma Linda, CA 92354-3128 | 2016-06-02 |
| 1164879219 | Megan Ashley Olivas | Registered Nurse | 25455 Barton Rd, 204b, Loma Linda, CA 92354-3128 | 2016-05-18 |
| 1407202328 | Tiffiny Suzanne Pizzifred | Nurse Practitioner | 25455 Barton Rd, Suite 204b, Loma Linda, CA 92354-3128 | 2016-05-10 |
| 1679943054 | Rio Gutierrez Ocampo | Nurse Practitioner | 25455 Barton Rd, Suite 204b, Loma Linda, CA 92354-3128 | 2015-09-29 |
| 1164806329 | Mark R Weber | Physician Assistant | 25455 Barton Rd, Loma Linda, CA 92354-3128 | 2015-07-16 |
| 1457731572 | Mopelola Adetola Adeyemo | Internal Medicine | 25455 Barton Rd, Suite 206-a, Loma Linda, CA 92354-3128 | 2015-06-03 |
| 1073991287 | Micah Clement | Physician Assistant | 25455 Barton Rd, Loma Linda, CA 92354-3128 | 2015-05-08 |
| 1952713802 | Jack Pierre Dubois | Family Medicine | 25455 Barton Rd, Loma Linda, CA 92354 | 2014-05-27 |
| 1033554613 | Loma Linda Inland Consortium for Healthcare Education | Clinic/Center | 25455 Barton Rd, Suite 209-b, Loma Linda, CA 92354-3128 | 2013-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264337 | Apple Red Nutrition Services | Dietitian, Registered | 357 W. 2nd St, Suite #2, Loma Linda, CA 92354 | 2020-10-30 |
| 1013517960 | Kristina Pulliam Markey | Nurse Practitioner | 11234 Anderson Strreet, Loma Linda, CA 92354 | 2020-10-29 |
| 1932725645 | Dev Priya Singhvi | Student in an Organized Health Care Education/Training Program | 11332 Mountain View Avenue, Westerly Building, Suite C, Gme Office, Loma Linda, CA 92354 | 2020-06-18 |
| 1750901278 | Angela N Torres | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Emergency Medicine, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-04-24 |
| 1548899230 | Holistic Physical Therapy Inc. | Physical Therapist | 25003 Starr Str, Loma Linda, CA 92354 | 2020-04-03 |
| 1508494071 | Eric Allen | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Pediatrics, General, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-03-31 |
| 1730640244 | Rose Valley Rcfe | Assisted Living Facility | 11574 Poplar St, Loma Linda, CA 92354 | 2019-03-27 |
| 1336633676 | David A Lawrence | Student in an Organized Health Care Education/Training Program | Loma Linda University Hospital, 11234 Anderson St., Loma Linda, CA 92354 | 2018-06-20 |
| 1205329547 | Rachael Nicole Spady | Student in an Organized Health Care Education/Training Program | Loma Linda University Health - Obstetrics & Gynecology, 11234 Anderson St, Loma Linda, CA 92354 | 2018-06-12 |
| 1447756069 | Anthony Ernest Sanchez | Otolaryngology | 11332 Mountain View, Westerly Building Suite C, Loma Linda, CA 92354 | 2018-04-03 |
| Find all providers in zip 92354 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831616028 | Nile Orthopedic and Rehabilitation Association | Orthopaedic Surgery | 25805 Barton Rd # A106, Loma Linda, CA 92354-3814 | 2017-08-28 |
| 1811320849 | Siamak Yasmeh | Orthopaedic Surgery | 11406 Loma Linda Dr Ste 226, Loma Linda, CA 92354-3711 | 2013-08-13 |
| 1568720811 | Rebecca A Rajfer | Orthopaedic Surgery | 11406 Loma Linda Dr Ste 218, Loma Linda, CA 92354 | 2012-04-24 |
| 1184745580 | Gary Lewis Painter | Orthopaedic Surgery | 11354 Mountain View Ave Ste A, Loma Linda, CA 92354-3855 | 2007-04-03 |
| 1699704023 | Wayne K Cheng | Orthopaedic Surgery | 25805 Barton Rd Ste A106, Loma Linda, CA 92354-3814 | 2006-06-30 |
| 1528443181 | Ronald Alan Roiz | Orthopaedic Surgery | 11406 Loma Linda Dr Ste 226, Loma Linda, CA 92354-3711 | 2015-07-24 |
| 1811375199 | Diana Starr Young | Orthopaedic Surgery | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2015-05-07 |
| 1881081396 | William Lee Frames | Orthopaedic Surgery | 11234 Anderson St, Gme Office Westerly Suite C, Loma Linda, CA 92350-1716 | 2015-04-22 |
| 1992065940 | Joseph Johnson | Orthopaedic Surgery | 11406 Loma Linda Dr, Loma Linda, CA 92354-3711 | 2012-05-24 |
| 1154689248 | Joseph Liu | Orthopaedic Surgery | 11406 Loma Linda Dr, Loma Linda, CA 92354 | 2012-04-26 |
| Find all providers in LOMA LINDA | ||||
| City | LOMA LINDA |
| Zip Code | 92354 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.