Organization Active NPI

Gayle Cekada MD Inc a Professional Medical Corporation

  • Internal Medicine Physician
  • San Luis Obispo, CA
National Provider Identifier
1033673173
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GAYLE CEKADA MD INC A PROFESSIONAL MEDICAL CORPORATION
Practice address
184 Casa St
San Luis Obispo, CA 93405-1804
Phone
(805) 903-1391
Fax
(805) 785-0367
NPI assigned
Jan 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Authorized official

Name
Gayle S. Cekada, MDNPI 1114996055
Title
President
Phone
(805) 903-1391

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

184 Casa St
San Luis Obispo, CA 93405-1804

Mailing address

184 Casa St
San Luis Obispo, CA 93405-1804
Phone (805) 903-1391

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190219000342 CA Part B Supplier - Clinic/Group Practice 5991043820 Receives reassigned benefits from 1 practitioner
Practice locations: San Luis Obispo, CA

National Provider Directory

National Provider Directory

Locations

1428 Phillips Ln
Ste 203
Sn Luis Obisp, CA 93401
Phone (805) 439-1797

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": "1548201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1033673173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 CASA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051804",
            "telephone_number": "805-903-1391",
            "fax_number": "805-785-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 CASA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051804",
            "telephone_number": "805-903-1391",
            "fax_number": "805-785-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAYLE CEKADA MD INC A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "CEKADA",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-903-1391",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.