Individual provider Active NPI

Antonio Mejia Gancayco, M.D.

  • Specialist
  • Anaheim, CA
National Provider Identifier
1104843960
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A50208 Issued in CA
Practice address
1164 N Euclid St
Anaheim, CA 92801-1900
Phone
(714) 778-0613
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A50208 CA Primary

Addresses

Primary practice location

1164 N Euclid St
Anaheim, CA 92801-1900

Mailing address

1164 N Euclid St
Anaheim, CA 92801-1900
Phone (714) 778-0613

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A50208CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Anaheim Global Medical Center, Inc Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
Kids Care Pediatrics Medical Group, Inc. Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1104843960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1164 N EUCLID ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011900",
            "telephone_number": "714-778-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1164 N EUCLID ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011900",
            "telephone_number": "714-778-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANCAYCO",
        "first_name": "ANTONIO",
        "middle_name": "MEJIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A50208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.