Active NPI
Gary Wikholm M D a Professional Corporation
- Family Medicine Physician
- Santa Paula, CA
National Provider Identifier
1053417725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- GARY WIKHOLM M D A PROFESSIONAL CORPORATION
- Practice address
- 247 W Harvard Blvd
Santa Paula, CA 93060-3223 - Phone
- (805) 525-0907
- Fax
- (805) 933-3392
- NPI assigned
- Sep 16, 2006
- Last updated
- Jan 28, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Agi Kessler
- Title
- Manager
- Phone
- (805) 525-0907
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | Primary |
Addresses
Primary practice location
247 W Harvard Blvd
Santa Paula, CA 93060-3223
Mailing address
247 W Harvard Blvd
Santa Paula, CA 93060-3223
Phone (805) 525-0907
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0085000 | Medicaid | CA |
Other names 1
- GARY WIKHOLM M D
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
539 Sespe Ave
Fillmore, CA 93015
Phone (805) 525-0907
247 W Harvard Blvd
Santa Paula, CA 93060
Phone (805) 525-0907
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Torrance, CA
- NPI 1629054929
-
- Family Medicine Physician
- Santa Paula, CA
- NPI 1861598526
-
- Nurse Practitioner
- Santa Paula, CA
- NPI 1346346046
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1769558400000",
"number": "1053417725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "247 W HARVARD BLVD",
"city": "SANTA PAULA",
"state": "CA",
"postal_code": "930603223",
"telephone_number": "805-525-0907",
"fax_number": "805-933-3392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "247 W HARVARD BLVD",
"city": "SANTA PAULA",
"state": "CA",
"postal_code": "930603223",
"telephone_number": "805-525-0907",
"fax_number": "805-933-3392"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GARY WIKHOLM M D A PROFESSIONAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-16",
"last_updated": "2026-01-28",
"certification_date": "2026-01-28",
"status": "A",
"authorized_official_last_name": "KESSLER",
"authorized_official_first_name": "AGI",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "805-525-0907",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0085000",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "GARY WIKHOLM M D",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Santa Paula, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; 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.