MRS. MARY IRENE GONZALES REY (NPI# 1770871576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770871576 |
| Entity Type | Individual |
| Full Name | MRS. MARY IRENE GONZALES REY |
| Other Name | MARY IRENE GONZALES MIRANDA |
| Credential | PA-C |
| Practice Address |
4950 Barranca Pkwy Ste 104 Irvine CA 92604-8644 |
| Mailing Address |
Po Box 3699 Newport Beach CA 92659-8699 |
| Practice Telephone | 9498571248 |
| Practice Fax Number | 9495591165 |
| Mailing Telephone | 6572413600 |
| Mailing Fax Number | 6572417708 |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2019-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | 16685 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 363A00000X | Physician Assistant | 21825 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE | CB275687 | 01 |
| CA | MEDICARE RAILROAD | P01319747 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 18785 Brookhurst St Ste 101, Fountain Valley, CA 927087300 | 7143780042 | 7149689129 |
| Street Address |
4950 BARRANCA PKWY STE 104 |
| City | IRVINE |
| State | CA |
| Zip Code | 92604-8644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356392278 | Coastal Family Medicine Inc | Family Medicine | 4950 Barranca Pkwy Ste 104, Irvine, CA 92604 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417643 | New Skin and Body Aesthetics Inc | Internal Medicine | 4980 Barranca Parkway, 201, Irvine, CA 92604 | 2020-11-02 |
| 1679091144 | Alan Chang | Pharmacist | 5385 Alton Parkway, Irvine, CA 92604 | 2017-09-06 |
| 1942751599 | Haleh Ranjijifroody | Chiropractor | 4980 Barranca Parkway Unit 200, Irvine, CA 92604 | 2016-10-19 |
| 1265982136 | Nora M Balke | Nurse Practitioner | 4968 Booth Cir Ste 110, Irvine, CA 92604 | 2016-10-04 |
| 1679945612 | Cvs Pharmacy | Pharmacist | 15333 Culver Drive, Suite 300, Irvine, CA 92604 | 2015-10-29 |
| 1184016230 | Keri Blasingame | Nurse Practitioner | 4980 Barranca Parkway Suite 200, Irvine, CA 92604 | 2015-02-26 |
| 1679979827 | Oc Women's Health,apc | Obstetrics & Gynecology | 14252 Culver Drive Suite A 499, Irvine, CA 92604 | 2014-11-17 |
| 1326443920 | Peter Sumarsono Professional Dental Corporation | Preferred Provider Organization | 4605 Barranca Parkway., 200, Irvine, CA 92604 | 2014-10-27 |
| 1164832218 | Abdiel Noe Hernandez | Driver | 14252 Culver Drive Ste A, Irvine, CA 92604 | 2014-04-29 |
| 1811315781 | Trisha Sharma | Internal Medicine | 6 Willard St, Kaiser Permanente- Barranca Medical Office Building, Irvine, CA 92604 | 2014-03-28 |
| Find all providers in zip 92604 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453541 | Stephen Benjamin Perez | Physician Assistant | 951 Somerville, Irvine, CA 92620-0264 | 2020-10-01 |
| 1922629831 | Lydia Yeeyen Lau | Physician Assistant | 14191 Saarinen Ct, Irvine, CA 92606-1853 | 2020-05-01 |
| 1053947184 | Shelby Harrison | Physician Assistant | 710 Oak Gln, Irvine, CA 92618-4718 | 2020-03-20 |
| 1174156194 | Chloe Tyau | Physician Assistant | 25 Pacifica Apt 5329, Irvine, CA 92618-3357 | 2020-02-18 |
| 1285285080 | Noura Aman | Physician Assistant | 12429 Spectrum, Irvine, CA 92618-3405 | 2019-09-23 |
| 1952810632 | Andrew Phan | Physician Assistant | 12 Villanova, Irvine, CA 92606-8929 | 2017-09-25 |
| 1194252395 | Sadie Mimi Kim | Physician Assistant | 263 Pineview, Irvine, CA 92620-1929 | 2017-05-18 |
| 1275084089 | Rosmarie Ahsan | Physician Assistant | 19191 Norwood Ter, Irvine, CA 92603-3511 | 2016-10-17 |
| 1730553173 | Darlene Vuong | Physician Assistant | 17 Skycrest, Irvine, CA 92603 | 2015-11-23 |
| 1407238942 | Jeanelle Lian Brick | Physician Assistant | 10 Whitecloud, Irvine, CA 92614-5447 | 2015-06-21 |
| Find all providers in IRVINE | ||||
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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.