Paul Edward Gourley, D.O.
Individual provider Active NPI Emergency Medicine Physician · Beale Afb, CA
NPI 1124015474 · NPPES record last updated Jul 7, 2015
Key facts
- NPI
- 1124015474
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 0102050040 (VA)
- Practice address
- 15301 Warren Shingle Rd
Beale Afb, CA 95903-1907 - Phone
- (530) 634-4838
- NPI assigned
- Oct 3, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102050040 | VA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colonial Emergency Physicians | Emergency Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 0102050040 | VA | Yes |
Addresses
Primary practice location
15301 Warren Shingle Rd
Beale Afb, CA 95903-1907
Mailing address
15301 Warren Shingle Rd
Beale Afb, CA 95903-1907
Phone (530) 634-4838
Other providers in Beale Afb, CA
- Miranda George
- Michell Marian Girton
- Alec Good
- Jessica Goodrich
- Amelia Tannarome Goodyear
- Erica Lizeth Gray
- Kayla Marie Hahn
- Timothy Lon Halpin
- Gregory Michael Hammond
- Michelle L Harring
All providers in Beale Afb, CA · Emergency Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.