Gregory Gullo MD PC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

MD26192 Issued in OR

Legal business name

GREGORY GULLO MD PC

Practice address

24076 SE Stark St
Suite 320
Gresham, OR 97030-3373

Phone

(503) 512-1212

Fax

(503) 512-1220

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gregory Gullo, MDNPI 1124075791

Title

President

Phone

(503) 512-1212

Specialties & licenses 1

Addresses

Other names 1

• Integrated Spine Care Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory Gullo, MD

  • Interventional Pain Medicine Physician
  • West Linn, OR
  • NPI 1124075791
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124105044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST",
            "address_2": "SUITE 320",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303373",
            "telephone_number": "503-512-1212",
            "fax_number": "503-512-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST",
            "address_2": "SUITE 320",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303373",
            "telephone_number": "503-512-1212",
            "fax_number": "503-512-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY GULLO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GULLO",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-512-1212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OR",
            "license": "MD26192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrated Spine Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dana Green
• Jamey Green, RDH, EPDH
• Shantika Green, LCSW
• Bryan James Greenaway, AU.D.
• Greene & Westermeyer PC
• Gresham Balance Body Works LLC
• Gresham DG LLC
• Gresham Downtown Dental Group, P.C.
• Gresham Family Dentistry, PC
• Gresham Internal Medicine Clinic

• Pain Medicine (Anesthesiology) Physician in Gresham, OR
• Providers in Gresham, OR by specialty
• Pain Medicine (Anesthesiology) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.