Active NPI
Gabrielle Burns, PA-C
- Surgery Physician
- La Jolla, CA
National Provider Identifier
1053047092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- PA64744
- Practice address
- 4150 Regents Park Row Ste 345
La Jolla, CA 92037-9102 - Phone
- (858) 207-3117
- NPI assigned
- Jul 30, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | PA64744 | CA | Primary |
Addresses
Primary practice location
4150 Regents Park Row Ste 345
La Jolla, CA 92037-9102
Mailing address
1500 N Renaissance Blvd NE Ste C
Albuquerque, NM 87107-7002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA64744 | CA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Medical Doctors | Multi-Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739750400000",
"number": "1053047092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 N RENAISSANCE BLVD NE STE C",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871077002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4150 REGENTS PARK ROW STE 345",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920379102",
"telephone_number": "858-207-3117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNS",
"first_name": "GABRIELLE",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-30",
"last_updated": "2025-02-17",
"certification_date": "2025-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": "CA",
"license": "PA64744",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.