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GNOSIS GERIATRIC WELLCARE CENTER INC
NPI 1962145029
Family Medicine in Garden Grove, CA

Active since April 18, 2022CLIA 05D2287078 · Waiver
12555 GARDEN GROVE BLVD STE 304, GARDEN GROVE, CA 92843(714) 353-5333 Get Directions Write a Review

NPPES record last updated: April 16, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Apr 16, 2023, Apr 18, 2022 (2 updates tracked since 2022).

About Gnosis Geriatric Wellcare Center Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GNOSIS GERIATRIC WELLCARE CENTER INC (NPI 1962145029) is a healthcare organization registered as a family medicine in Garden Grove, California and active in the NPI registry since April 2022. The organization holds a CLIA Waiver certificate valid through August 7, 2027 and lists Gerardo Canchola, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1962145029
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameGNOSIS GERIATRIC WELLCARE CENTER INC
Location Address12555 GARDEN GROVE BLVD STE 304Garden Grove, CA 92843-1903
Mailing Address2617 E Chapman AveOrange, CA 92869-3226
Phone(714) 353-5333
Organization SubpartNo
Authorized OfficialGerardo CancholaMedical Director · (714) 353-5333
Enumeration DateApril 18, 2022
Last NPPES UpdateApril 16, 20232 updates tracked since enumeration
NPPES CertifiedApril 16, 2023
✔ NPI 1962145029 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedGeneral PracticeTaxonomy 208D00000X
Also ListedClinic/CenterTaxonomy 261Q00000X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
12555 GARDEN GROVE BLVD STE 304, Garden Grove, CA 92843
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gnosis Geriatric Wellcare Center Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Gnosis Geriatric Wellcare Center Inc, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Gerardo Canchola, M.D.
Family Practice
NPI 1639185879
2621 S BRISTOL ST STE 302
Santa Ana, CA 92704
(714) 662-7710
✔ PECOS✔ Accepts Medicare4.6 mi
Rene Kohlieber, M.D.
Family Practice
NPI 1720377492
4950 W SUNSET BLVD 4TH FLOOR
Los Angeles, CA 90027
(323) 783-7899
✔ PECOS✔ Accepts Medicare31 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2287078

Gnosis Geriatric Wellcare Center Inc · Garden Grove, CA
Active · expires Aug 7, 2027
CLIA Number05D2287078
Laboratory TypePhysician Office
Certificate Effective DateAugust 8, 2025
Certificate Expiration DateAugust 7, 2027
Laboratory DirectorGerardo Canchola
Laboratory Phone(714) 353-5333
Laboratory LocationGnosis Geriatric Wellcare Center Inc12555 Garden Grove Blvd, Ste 304, Garden Grove, CA 92843
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gnosis Geriatric Wellcare Center Inc's NPI number?

The NPI number for Gnosis Geriatric Wellcare Center Inc is 1962145029. It was assigned to this organization in the NPPES registry on April 18, 2022.

Where is Gnosis Geriatric Wellcare Center Inc located?

Gnosis Geriatric Wellcare Center Inc is located at 12555 Garden Grove Blvd Ste 304, Garden Grove, CA 92843. The listed phone number is (714) 353-5333.

What is Gnosis Geriatric Wellcare Center Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Gnosis Geriatric Wellcare Center Inc enrolled in Medicare?

Yes. Gnosis Geriatric Wellcare Center Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Gnosis Geriatric Wellcare Center Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Family Practice, reassign their Medicare billing to Gnosis Geriatric Wellcare Center Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Gnosis Geriatric Wellcare Center Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2287078) is associated with this NPI, valid through August 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Gnosis Geriatric Wellcare Center Inc was last updated on April 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.