Active NPI
Sydney Rebecca Gunn, PA-C
- Physician Assistant
- Santa Monica, CA
National Provider Identifier
1083998157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5021
- Practice address
- 510 Wilshire Blvd Ste 101
Santa Monica, CA 90401-1404 - Phone
- (310) 400-6181
- NPI assigned
- Oct 6, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5021 | AZ | Primary |
Addresses
Primary practice location
510 Wilshire Blvd Ste 101
Santa Monica, CA 90401-1404
Mailing address
4237 Via Marina Apt 501
Marina del Rey, CA 90292-4555
Phone (310) 985-7878
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1094077 | Other | NCPAA # |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5021 | AZ | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714348800000",
"number": "1083998157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4237 VIA MARINA APT 501",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902924555",
"telephone_number": "310-985-7878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 WILSHIRE BLVD STE 101",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904011404",
"telephone_number": "310-400-6181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNN",
"first_name": "SYDNEY",
"middle_name": "REBECCA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-06",
"last_updated": "2024-04-29",
"certification_date": "2024-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "5021",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPAA #",
"identifier": "1094077",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.